Boundaries: Thoughts on Building and Maintaining “Good Fences”

Why is it important to set and adhere to healthy boundaries? How can you tell if yours are weak?

By Cassie Jewell, LPC, LSATP

“Good fences make good neighbors.”

Robert Frost

When I picture a boundary, I imagine drawing a circle with a stick in the dirt… with me in the middle. I stay in; everyone else stays out. Boundaries are protective; they keep us safe. Without boundaries, you have no limits, no sense of direction. Without boundaries, you open yourself up… anyone can come in, with good or bad intentions.

If you have poor boundaries in a dating relationship, you could end up doing things you’re not comfortable with. Or, another example might be with your boss; if you don’t set firm limits, you could end up taking one extra tasks.

I once worked with a client who regularly violated his partner’s boundaries by yelling, “Phone check!” whenever he wanted to check his girlfriend’s cell. She’d hand it over and he’d review her calls/read her texts. It was a boundary violation for sure. Everyone has a right to privacy. (That being said, your partner never has the right to go through your phone, read your journal, request your social media passwords, etc. Those are all boundary violations; they could also indicate that the relationship is in trouble.)

Another way to conceptualize a boundary is to picture mosquito netting. It keeps the mosquitoes out, but it’s flexible and lightweight. It lets in air, sunlight, a cool breeze… A mosquito net is a healthy boundary. If you were to instead build a brick structure, you’d be doing a lot of unnecessary work and you’d probably still get bit.  

It’s best to be up front and honest about the boundaries you set (which requires assertiveness). With your boss, the first time he asks if you can stay late on a Friday, you might end up saying yes. (It’s probably just a onetime thing, right?) Seeing that you don’t say no the first time, he may continue to ask you to stay late or take on extra work. The alternative (boundary-setting) option would be to say (when he first asks), “I’m sorry, although I’d love to be able to, I have a policy against being away from home on Fridays. It’s family night at my house.” It’s unlikely he’ll ask you again because you very firmly (and politely) set a boundary.

On the other hand, if you’re passionate about your career, you could be flexible and stay late (especially if you’re hoping for a promotion or a raise) without feeling as though your boundaries have been violated. The important thing is to know where you stand (i.e. what your boundary is).

Equally important to setting boundaries is adhering to them once they’re established. There are people out there who love to test boundaries. A boundary is useless without follow through. Your boundary becomes meaningless if you say you’re not going to do something and then you do it anyway. If you tell your child “no candy before dinner,” but then finally give in after several bouts of dramatic tears, you’re sending a message. The message is “When I say no, I don’t mean it.” It’s important to be consistent with boundaries.

Signs of Weak Boundaries

  • A lack of assertiveness
  • Altering your personal values for someone (especially in a romantic relationship)
  • Having a sexual relationship with someone when you’re not ready
  • Not being able to say “no”
  • Trusting others quickly (when it’s not warranted)
  • Falling in love quickly or believing an acquaintance is your best friend when you only met the day before

Rigid boundaries, on the other hand, are at the opposite end of the spectrum. A person with rigid boundaries doesn’t trust easily or let others in. It would be difficult to be in an intimate relationship with a person with rigid boundaries.

How to Develop Healthy Boundaries

Firstly, know that it will take time. Be patient with yourself and don’t criticize yourself if you fall back into old habits.

Recognize (and accept) your right to establish and adhere to personal boundaries. Read one of Dr. Cloud’s books on boundaries or Melody Beattie’s Codependent No More. Personally, I like Co-dependents Anonymous’ recovery literature. It’s an easy read (four pages) and you can access it for free.

If you haven’t already, take time to clarify your values. You can do a values sort – there are plenty of free resources online. It’s something I frequently do with my clients. What’s most important to you? Family? Integrity? Kindness? Have unhealthy boundaries affected this value in the past? (If kindness is most important to you, and you identify as a “people pleaser,” consider all the times you’ve been unkind to yourself. Explore ideas for practicing kindness to both others and self.)

Also, deliberate on the behaviors you find unacceptable (in terms of how you’re treated). Looking back on past relationships, I dated men who cheated on me, called me names, were mean to my friends, and yes, even checked my phone. Completely unacceptable. At this point in my life, I have a zero tolerance policy.

When you establish boundaries, especially with those who don’t expect it (i.e. your mother-in-law or the neighbor who regularly lets his dog romp through your garden), anticipate some push back. It probably won’t feel good in the moment.

Practice assertiveness. Don’t back down. If someone is particularly resistant, don’t engage in an argument.  You don’t owe an explanation. You don’t even have to respond. Remain calm; walk away if needed. If it helps, pre-plan your exact wording. (“I’m sorry, but I’m no longer able to stay till 9 on Fridays. Unexpected circumstances at home won’t allow it.”) Be concise. Don’t be overly apologetic.

If the person you’re setting boundaries with is a significant other or family member, I’d recommend transparency. Let them know that you’re going to make some changes. Share how unhealthy boundaries have negatively impacted you. (Give specific examples if you can.) Don’t place blame. Talk about how healthy boundaries will positively impact not just you,but the relationship. It may still be difficult. There may be some tension; the relationship might feel strained. (And it’s okay.)

If you set boundaries and find them repeatedly violated; firstly, take a step back and reevaluate the situation. Have you been clear and consistent? If so, you may want to consider spending less time with this person or even ending the relationships. Unfortunately, while you can set boundaries, you can’t force someone to respect them.


In sum, boundaries are imperative. Skin is a boundary that keeps other organs in place; it shields our body systems from toxins, viruses, and bacteria that would otherwise be deadly. It keeps the bad stuff out (and the good stuff in). Healthy boundaries are our emotional skin. If you need a boundaries tune up, it could take some effort, but is well worth it. You’ll experience increased satisfaction in your relationships and will feel more confidence.Your overall well-being will improve; boundaries are freeing – by communicating your needs, it’s less likely you’ll feel angry or resentful. And lastly, you’ll find that others have a greater level of respect for you. “Good fences,” it would seem, are not limited to neighbors!

Worksheets, Activities, & Guides for Individual or Group Therapy

A list of free PDF printable worksheets and activities to use with clients in individual or group sessions

By Cassie Jewell, LPC, LSATP

This is a (short) list of worksheets, activities, and discussion guides I created and have used with clients. Feel free to print/reproduce/share. Please check back frequently as I will update regularly!


A list of check-in prompts to use with each group member at the beginning of a group

Print/cut these cards, fold, and place in a bag or box. In group, have clients take turns drawing cards and answering the questions.

A group icebreaker activity! Print/cut the cards, fold, and place in a bag or box. Group members take turns drawing the cards and answering the questions.

A recovery worksheet for clients to explore what makes their drug/alcohol use possible and how to eliminate those things from their life

A recovery worksheet for clients to explore how they will find pleasure and fulfillment in recovery from addiction

A goal-development worksheet

A worksheet for developing goals for different life areas, such as emotional, spiritual, intellectual, etc.

A worksheet for developing self-esteem

A guide for clients to explore their true selves

Characteristics of an Effective Clinical Supervisor

“It was the bad supervisors who taught me what NOT to do.”
Are you an effective clinical supervisor? What is helpful… and unhelpful in supervision? Read about Reddit users’ experiences with clinical supervision, including the traits of “bad” supervisors.

By Cassie Jewell, LPC, LSATP

Shortly after being trained and approved as a clinical supervisor, I took on my first supervisee (whom I’ll call “DM”). I was confident in my abilities and knowledge as a counselor, but quickly learned it takes more than skill or expertise to provide effective supervision.

In one of my first sessions with DM, I inadvertently offended her (and thereby damaged our newly forming rapport). We were discussing personal and professional growth, which led to a “bucket list” discussion. I shared how I’d always wanted to do a police ride-along; DM immediately stated that as an African American woman, this was distasteful to her. Unfortunately, I missed my cue and continued to talk about how exciting it would be. Meanwhile, she felt disrespected. In this instance, I got carried away with talking about myself and my interests, ignoring her feelings on the subject. I came across as ignorant, in the least, and at worst, culturally insensitive or uncaring.  

Another time, I suggested that DM (who held a doctorate degree in counseling) stop referring to herself as “Dr. ____,” as it caused confusion when coordinating with outside agencies. Once again, she felt upset and misunderstood. She later explained that I failed to take into account all she had overcome to earn that degree. It was more than a title to her; it represented triumph in the face of adversity. Furthermore, it was a piece of her identity as a helper and as a role model to African American women. Although well-intended, my suggestion was offensive on several levels. In hindsight, I could have explored how she viewed herself as a professional or simply asked why she called herself “Dr. ____” before commenting.  


Self-awareness is crucial for effective supervision and self-care is essential for coping with stress.   

More recently, a different supervisee (whom I supervise both clinically and administratively) told me that I had been acting out of character by “harping” on her about completing various assignments. I checked myself and was able to recognize my high level of stress was indeed impacting our interactions. Self-awareness is crucial for effective supervision and self-care is essential for coping with stress.   

Reversing roles, looking back on supervisors I had in grad school and as a new counselor, I can recall what was beneficial and what wasn’t (or was annoying/upsetting/disturbing… even unethical). What helped the most was direct feedback, along with specific suggestions for improvement. Constructive criticism, while unpleasant, made me a better clinician (and probably a better person). Feeling supported and having my doubts or fears normalized was also helpful.


The bad supervisors taught me what not to do.

On the flip side, unhelpful, “bad,” supervisors were the ones who rambled on about their clients, micromanaged, were punitive, or who never met for supervision. There was even one who called me a hurtful name; the comment came from a misunderstanding, but I took it to heart. It was inappropriate and unprofessional; I carried it for a long time. The bad supervisors taught me what not to do.  

This post was inspired by my desire to learn more about what makes supervision effective. I looked to Reddit for others’ experiences and opinions and asked what’s most (and least) helpful in clinical supervision.

Gr8minds is a master’s student and MFT trainee who wrote, “For myself, what I find most helpful is when my supervisor shares questions I may have not thought of about the client’s case. This really helps give a second pair of eyes and I can take those into the next session.”

Questions are as fundamental to supervision as they are to the counseling process. A question inspires contemplation and may lead to a new understanding. An effective supervisor asks thoughtful questions about the client, their upbringing, their beliefs, etc., providing the supervisee with valuable tools to use with their clients.

RomeRawr, a doctoral student, shared about a self-centered supervisor who used sessions to talk about their clients instead of promoting the supervisee’s growth. “What I’ve found least helpful is my supervisor complaining to me about clients. Not conferencing, or asking my opinion, but just complaining to unload.”

A supervisor who complains/vents about clients should not be in a supervisory role. It’s one thing to consult, but to complain shows a lack of empathy and professionalism. It makes me question why that person is even in the field.

To an extent, I can relate; I previously mentioned a “bad” supervisor who, while he didn’t complain, regularly discussed his difficult cases in group supervision. This is how it would go: Dr. BS (Bad Supervisor) would present a case and then seek our (the students’) opinions. He had the audacity to take notes. When we were provided with (rare) opportunities to talk about our clients, he’d make comparisons to his private practice… and seek advice (un-cleverly disguised in the form of, “Well, what do you think you [I] should do?”)

While it can be helpful for a supervisor to share client stories, it should only be as a teaching tool (or to convey empathy). Similarly, a counselor should self-disclose for the client’s benefit, never their own.

grace_avalon, clinical counselor, holds a master’s degree and has been licensed in Minnesota for over a year. “I’ve had so many supervisors. The best ones worked me hard, required consultation with every DA (a word-for-word transcript of a counseling session)… [were] highly involved and observed me closely, tirelessly… and responded neutrally and understood my tears. We met privately, which was pivotal to growth.”


A supervisor can’t be a gatekeeper if they don’t know to close the gate.

An effective supervisor expresses empathy; they’re not reactive. An effective supervisor is also dedicated; they strive to help the supervisee by observing his/her interactions with clients and/or reviewing lengthy transcripts. A lazier supervisor might give advice/feedback based solely on the supervisee’s report, which is subjective. There’s a place for this in supervision, but it can’t be the only method of assessing a supervisee’s skill. Reviewing recorded sessions or transcripts is time-consuming (and, not gonna lie, boring), but imperative for a counselor’s growth. (It should also be noted that a supervisor can’t be a gatekeeper if they don’t know to close the gate.)

_PINK-FREUD_ is a clinical psychology doctorate student (with an MA in clinical psychology) who provides therapy to children, adolescents, and families. “My most helpful supervisor taught me to examine how my history comes into the room with clients. For example, my very first client told me something painful about a learning disorder and I responded with humor. Basically achieved the polar opposite of attunement. The footage was cringeworthy af. She didn’t shame me about it (of course, I was shaming myself anyway), but just inquired as to why I did that I realized I’ve dealt with my own LD with humor and by “laughing it off,” which led me to automatically and inappropriately apply that same response to my client… That supervisor showed me to move past the shame of making mistakes and towards understanding why I made that mistake. She led me through that process of self-examination countless times, and it taught me to do it independently.”

Being aware, both self and of what the client/supervisee is experiencing, is a vital component of counseling and supervision. In fact, many of my early (and more recent) mistakes could have been avoided had I been more attuned.

_PINK-FREUD_  also shared, “Another good supervisor trait IMO is someone who does not guess why a mis-step was made. I’m currently working on interrupting my clients more instead of letting them ramble –something I think mainly stems from the very common newbie clinician fear of invalidating or injuring the client. That supervisor pointed out my mis-step, then spoke about my need to “be friends with clients,” which felt off to me. When I tried to express that, I was perceived as defensive about having poor boundaries. It really broke my trust with that supervisor. I felt that he had made blind judgments about my underlying motivations for responses without listening to my explanation. It made it difficult for me to go to him for help with tough cases as I was afraid of the conclusions he would jump to. ASK, don’t tell your students for their motivations. It builds trust that you seek to understand them and also teaches them how to do this independently.”

Similarly, it broke trust when one of my “bad” supervisors called me a name. She made an assumption based on a blind judgment. Assumptions, sometimes true, but more than often not, have no place in supervision (or counseling). Going back to awareness, it’s important for a supervisor to recognize when they’re making assumptions.

alfredo094, an undergraduate student, shared that as a supervisee, “having [a supervisor] that knows me very well and listens to everything that happened to the session in detail is important.”

As counselors, we listen to what our clients say. By listening, we learn and are able to provide support and guidance. The same is true for supervisors. Listening and being fully present with the supervisee will help him/her to become a better counselor.

What are some of your experiences in supervision? Share in a comment!

Top 40 Most Disturbing Mental Health Posts on Quora

What questions are people asking about mental health? Quora posts indicate that misconceptions and myths related to mental illness and addiction prevail. Read the top 40 most unsettling questions on Quora.com.

By Cassie Jewell, LPC, LSATP

I conducted a Facebook poll to ask about knowledge of mental health. A majority of the respondents (83%) viewed themselves as “very or quite knowledgeable.” Only 17% of those polled reported having little (or no) knowledge.

However, it’s unlikely that my small sample size is representative of the general population. There are many common myths out there about mental health and addiction.

I turned to Quora (an online platform for asking questions) to see what individuals who view themselves as less informed may be asking about mental illness. What I found ranged from thought-provoking to comical to disturbing.

Continue reading for 40 of the most unsettling inquiries I came across. The following Quora question posts illustrate some of the misconceptions surrounding mental disorders.

1. “Is mental illness really an illness?”

2. “Is mental illness catchable?”

3. “Do people with mental disorders have friends?”

4. “Are people who self-harm just looking for attention?”

5. “Is drug addiction really just a lack of willpower?”

6. “Can a person be intelligent and a drug addict?”

7. “Should drug addicts be left to die?”

8. “Why can’t drug addicts just stop? What compels a person to continue with a destructive behavior despite the obvious problems their behavior causes?” (Note: Addiction is a brain disease, which is why someone struggling with substance abuse can’t “just stop.”)

9. “Why should one feel sorry or sympathetic for drug addicts, given most of them chose this life?”

10. “Instead of ‘rescuing’ drug addicts who have overdosed, wouldn’t society as a whole benefit from just letting nature take its course?” (If that was the case, shouldn’t we then withhold all types of medical treatment and preventative or life-saving measures… to allow nature to take its course?)

11. “Is there any country in the world that won in the war against drugs by killing the users or the drug addicts?”

12. “Why should we lament drug addicted celebrities dying of drug-related causes? It’s their fault for starting a drug habit.”

13. “Why save drug addicts from overdosing? From my experience they were problems for their families, a drain on society from their teen years, and won’t get better once addicted.” (All diseases are a drain on society to an extent; that doesn’t mean lives aren’t worth saving.)

14. “How do you differentiate between drug addicts and real homeless people when giving money?” (You don’t; find other ways to help.)

15. “What are the best ways to punish an alcoholic?”

16. “Don’t you think it’s time we stop spreading the myth that alcoholism is a disease? You can’t catch it from anyone. One chooses to drink alcohol.”

17. “Why do people who are oppressed/abused never defend themselves and have pride?”

18. “Why don’t I have empathy for people who end up in abusive or unhealthy relationships? I feel that they deserve it for being such a poor judge of character.”

19. “Why do most women put up with domestic violence?” (Most women?? “Put up”??)

20. “Are schizophrenics aware they’re crazy?”

21. “Are schizophrenic people allowed to drive?”

22. “Do people who become schizophrenic become that way because they are morally conflicted?”

23. “Are schizophrenics able to learn?”

24. “Can a schizophrenic be coherent enough to answer a question like ‘What is life like with schizophrenia?’ on Quora?”

25. “Can one ‘catch’ schizophrenia by hanging out too long with schizophrenics?”

26. “Can schizophrenics have normal sex?” (Yes, or kinky, whichever they prefer)

27. “Why do people ignore the positive impact spanking has on raising children?” (See #28)

28. “Is being spoiled as a child a cause of mental illness such as depression?” (No, but spanking is linked to mental disorders and addiction in adulthood.)

29. “Should mentally ill people be allowed to reproduce?”

30. “Should people with mental illness be allowed to vote?”

31. “Are we breeding weakness into the gene pool by treating and allowing people with physical and mental illnesses to procreate?”

32. “Why are we allowing mental illnesses of sexual orientation disturbance and gender identity disorder that were changed for political reasons, to be accepted like race?”

33. “Why do some people with mental illness refuse to work and live off the government when they are perfectly capable of working?”

34. “Why are mentally disturbed women allowed to have children?”

35. “I feel no sympathy for the homeless because I feel like it is their own fault. Are there examples of seemingly “normal” and respectable people becoming homeless?”

36. “How is poverty not a choice? At what point does an individual stop blaming their parents/society/the government and take responsibility for their own life?” (White privilege at its finest)

37. “Why are mental disorders so common nowadays? Is it just an “excuse” to do bad or selfish things?”

38. “Are most ‘crazy’ people really just suffering from a low IQ?”

39. “Why do some people have sympathy for those who commit suicide? It is very cowardly and selfish to take your life.”

40. “Is suicide part of the world’s survival of the fittest theory?”

Please leave your thoughts/feedback in a comment!

Free Printable PDF Workbooks, Manuals, and Self-Help Guides

A resource list for mental health professionals and consumers. Free PDF manuals/workbooks for group and individual therapy or self-help purposes.

Compiled by Cassie Jewell, LPC, LSATP

Updated March 9, 2019

free printables

The following list is comprised of links to over 100 PDF workbooks, manuals, and guidebooks that are published online and free to use with clients and/or for self-help purposes. Some of the manuals, including Individual Resiliency Training and Cognitive Behavioural Therapy for Psychotic Symptoms, are evidence-based.

12 Step Workbooks
Acceptance and Commitment Therapy for PTSD: Group Manual
Adult Coloring Book for Mindfulness and Relaxation 
After an Attempt: A Guide for Taking Care of Yourself After Your Treatment in the Emergency Department (Spanish Version)
After an Attempt A Guide for Taking Care of Your Family Member after Treatment in the Emergency Department (Spanish Version)
Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook (Spanish Version) (Provider Manual)
Anger Management Workbook
Anxiety Toolbox: Student Workbook
Back To Life: Your Personal Guidebook to Grief Recovery
Basic Anxiety Management Skills
Brief Counseling for Marijuana Dependence: A Manual for Treating Adults
CBT Worksheet Packet, 2017 Edition (Beck Cognitive Behavioral Therapy)
Client Workbook (from the Substance Use | Brain Injury Bridging Project)
Cognitive Behavioural Interpersonal Skills Manual
Cognitive Behavioral Therapy for Depression: Activities and Your Mood (Individual Treatment Version) Provider’s Guidebook
Cognitive Behavioral Therapy for Depression in Veterans and Military Servicemembers: Therapist Manual 
Cognitive Behavioral Therapy for Insomnia (CBTi): Treatment Manual
Cognitive Behavioural Therapy for Psychotic Symptoms: A Therapist’s Manual
Cognitive Behavioural Therapy Skills Training Workbook
Cognitive Processing Therapy Veteran/Military Version: THERAPIST AND PATIENT MATERIALS MANUAL
The Complete Set of Client Handouts and Worksheets from ACT books by Russ Harris
Comprehensive Cognitive Behavior Therapy for Social Phobia: A Treatment Manual
Co-occurring Disorders Problem Gambling Integrated Treatment Workbook
Co-occurring Disorders Treatment Workbook
Coping With Anxiety
Creating a Healthier Life: A Step-by-Step Guide to Wellness (Spanish Version)
Dealing With Distress
Dealing With Trauma: A TF-CBT Workbook for Teens
Depression Self-Management Toolkit
Determine Your Destiny (Self-Determination Series)
Eating Disorders Anonymous Step Workbook
Favorite Therapeutic Activities for Children, Adolescents, and Families: Practitioners Share Their Most Effective Interventions
Forgiveness Workbook: A Step by Step Guide
Generalized Anxiety Disorder: Patient Treatment Manual
Group Cognitive Behavioral Therapy for Depression: Thoughts and Your Mood
Guidebook on Vicarious Trauma: Recommended Solutions for Anti-Violence Workers
Happiness 101 Workbook
Happy for No Reason Workbook
Healthy Relationships Toolkit
HERO: Healthy Emotions and Improving Health Behavior Outcomes (Veteran Workbook)
Hope Focused Self-Help Workbook
The ‘Hurt Yourself Less’ Workbook
Illness Management and Recovery: Practitioner Guides and Handbooks
Individual Resiliency Training
Interpersonal Psychotherapy for Depression in Veterans: Therapist Guide
ISLAMIC INTEGRATED COGNITIVE BEHAVIOR THERAPY: 10 Sessions Treatment Manual for Depression in Clients with Chronic Physical Illness (Therapist Manual Workbook)
Johari Window Workbook
A Journey Toward Health and Hope: Your Handbook for Recovery After a Suicide Attempt
Just as I Am Workbook: A Guided Journal to Free Yourself from Self-Criticism and Feelings of Low Self-Worth
Lemons or Lemonade? An Anger Workbook for Teens
Life With Hope: 12 Step Workbook from Marijuana Anonymous
Manage Stress Workbook
Mapping Your Recovery
Matrix Series (Intensive Outpatient Treatment for People with Stimulant Use Disorders): Client’s Handbook
Matrix Series (Intensive Outpatient Treatment for People with Stimulant Use Disorders): Client’s Treatment Companion
Matrix Series (Intensive Outpatient Treatment for People with Stimulant Use Disorders): Counselor’s Family Education Manual
Matrix Series (Intensive Outpatient Treatment for People with Stimulant Use Disorder): Counselor’s Treatment Manual
Matrix Series: Using Matrix with Women Clients
Mindfulness and Acceptance-Based Group Therapy for Social Anxiety Disorder: A Treatment Manual
Mindfulness-Based Stress Reduction (MBSR): Authorized Curriculum Guide
The Mindful Path through Shyness
Motivational Enhancement Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse and Dependence
My Wellness Action and Recovery Plan (WRAP)
My Action Plan for Relapse Prevention
On the Wings of Grief: A Bereavement Journal for Adults
Open-Minded Thinking (DBT Workbook)
Opioid Overdose Prevention Toolkit
Personal Brand Workbook
PREPARE/ENRICH Workbook for Couples
A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals
Reaching out to a Hurting World: Christ-Centered Workbook on Recovery and Coordinating Twelve-Step Meetings
REBT Depression Manual: Managing Depression Using  Rational Emotive Behavior Therapy
Refine Your Life Workbook
Relapse Prevention Workbook
The Relaxation and Stress Reduction Workbook
Remembering For Good: Wholehearted Living after Loss
Self-Care Depression Program: Antidepressant Skills Workbook
Self-Help Manual for Bulimia Nervosa
Self-Help Workbook: Calming Tools to Manage Anxiety
Simple CBT Worksheets (from Autism Teaching Strategies)
SMART Recovery Worksheets
Social Anxiety in Schizophrenia: A Cognitive Behavioural Group Programme
Social Emotional Activities Workbook
Social Skills Training for Severe Mental Disorders: A Therapist Manual
The Stages of Divorce
STEP AHEAD Workbook: Career Planning for People with Criminal Convictions
Steps by the Big Book
Substance Misuse Workbook
Survivor To Thriver: Manual and Workbook for Adult Survivors of Child Abuse Who Want to Move On with Life
A Therapist’s Guide to Brief Cognitive Behavioral Therapy
The Think CBT Workbook
Think Good – Feel Good
Tobacco Cessation: An Abbreviated Mini-Workbook (A Resource for Veterans)
Treatment of Individuals with Prolonged and Complicated Grief and Traumatic Bereavement
Trauma and Resilience: An Adolescent Provider Toolkit
The Trauma-Informed Supervisor
Understanding Depression
Wellness Action Recovery Plan (WRAP): Personal Workbook
Wellness Self-Management Personal Workbook
Wellness Worksheets, 12th Edition
What Do You Want to Do with Your Life? Your Life Plan to Find Your Answer
Women Healing from Trauma: A Facilitator’s Guide
Working Through Self-Harm: A Workbook
Working Toward Wellness
Your Best You: Improving Your Mood

Please comment with links to additional PDF resources for therapy or self-help!

Why Language Matters: 4 Words/Phrases to Stop Saying

Words have power. They are impactful. They can contribute to stigma and divide humanity. To help fight stigma, change your language.

By Cassie Jewell, LPC, LSATP

Have you ever been called a bitch? A creep? A whore? An idiot? Maybe someone said you were lazy or worthless or stupid. Words can hurt. They have power. (Consider the power of your name spoken aloud… you immediately respond by answering or turning your head… the sound commands your attention and response.)

Furthermore, words are impactful… not only for the person being labeled, but for an entire group of people. They contribute to stigma while fueling biases. They divide humanity. Retard. White trash. Crazy. Junkie. Nigger. Slut. Spic.

addiction7

A while back, a colleague made a racial slur in my presence. He seemed unaware, so I gently corrected him; he immediately lashed back, calling me the “PC Police.” Not only did this person perceive the slur as perfectly acceptable, he seemed to have a negative perception of “political correctness.” It was a joke to him: “People need to stop being so sensitive!” (Um, no… maybe people need to stop being degrading to each other!)

Honestly, I have trouble understanding the negativity surrounding political correctness. Why strive for anything other than accuracy? (Especially knowing the power language holds.)

stigma

If you side against ignorance and want to end the stigma associated with mental illness, change your language. The following words or phrases contribute to stigma:

“Addict”

There are many negative connotations surrounding this word. Similarly, “alcoholic” can be demeaning. A person who is addicted to drugs or alcohol has a medical condition. Instead of calling them an addict (or junkie or tweaker or crackhead), say “individual with a substance use disorder.” Demonstrate the same empathy you would for a person who has cancer or MS or paralysis.

epedemic3

“Schizophrenic”

Don’t label a person who suffers from mental illness. They are more than the disorder they’re afflicted with. Calling someone “schizophrenic” or “borderline” or “bipolar” reduces them to an illness, not a person. It’s dehumanizing.

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“Retarded”

True, “mental retardation” used to be the diagnostic terminology for classifying individuals with lower IQs. Today, however, it’s mostly used as an insult. The American Psychiatric Association has eliminated the term as a classification; the correct term is “intellectual disability.”

stigma2

“Committed suicide”

This phrase suggests that the person who dies by suicide is criminal. Criminals commit crimes. An individual who dies by suicide should not be placed in the same category. Instead, say “died by suicide.” This demonstrates respect for both the individual and their loved ones.

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Words have the power to influence and shape the world. You have power. Be a positive influence and choose to fight stigma instead of contributing to the toxicity.

 

#JunkieLivesDontMatter

A person who struggles with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more DESERVING lives.) “Junkies” don’t deserve second chances because #JunkieLivesDontMatter

By Cassie Jewell, LPC, LSATP

epedemic2

Disclaimer: If you happen to believe that addiction is a choice – “They’d quit if they really wanted to” or “They made the choice to use; they made the choice to die” – then scroll on to the next blog. You’d only scoff at this post because #JunkieLivesDontMatter

epedemic4

This blog post is inspired, in part, by a Facebook meme.

The meme said,

“So if a kid has an allergic reaction the parents have to pay a ridiculous price for an Epi pen. But a junkie who has OD’d for their 15th time gets Narcan for free? What a screwed up world we live in.”

Implications: “Junkies” don’t deserve a second chance at life. They’re a waste of resources because they lack the willpower to stop using. A person who struggles with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more deserving lives.)

If you believe it’s screwed up for a “junkie” to have a chance at life (and recovery) because they “chose addiction,” your opinion is contrary to the National Institute of Health, the American Medical Association, the American Psychiatric Association, and decades of scientific research. You’re either ignorant (maybe willfully so) or impressively arrogant. (Alternately, you could just be a jerk.) You’re a part of the movement: #JunkieLivesDontMatter

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Many have joined the movement, as evidenced by the following Facebook posts:

“Out of all of the houses, 2 hobos decided to overdose on my front steps… thank god the medics got here in time to ensure they could die another day…”

“I think we had less ODs before Narcan came on board. They realize they can be saved if gotten to in time. Maybe they need to be locked up & not let out until they attend rehab while in jail.”

“If it can be easily established that they have a recent history of drug [abuse]… then yes… withhold the lifesaving drug because they chose this. It’s harsh, but justice is not served by saving them.”

“If you don’t have it figured [out] by the 3rd overdose, you are just prolonging the inevitable and wasting tax payers money.”

“If we are repeatedly saving your life and you are not willing to change this behavior, why should we be obligated to keep saving you?”

“My personal opinion is we can’t keep letting people overdose and saving them just so they can repeat the cycle.”

“By continuously administering Narcan, sure, we’re saving their life, but are they really living? I don’t think so.”

#JunkieLivesDontMatter

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“No CPR for You, Fatty — You Chose Soda and Fast Food… Now Suffer the Consequences!”

According the the American Psychiatric Association,

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems.

Addiction is a scientifically proven brain disease. Despite this, many persist in the belief that it’s a choice, or worse… a moral failing. (Note: This notion comes from an early model of addiction, “the moral model,” which was deeply rooted in religion. Addiction was attributed to a sinful nature and weakness of character. Therefore, the addict must repent… or suffer the consequences of his/her actions; addiction warranted punishment, not empathy. Unsurprisingly, this created stigma. It also prevented those struggling with addiction from seeking treatment. Centuries later, many hold on to the view that an individual suffering from a substance use disorder is lazy or weak.)

Today, in the midst of the opioid epidemic, stigma’s unrelenting grip perseveres. Stigma is a poison; it’s dehumanizing. It’s easy to forget a person is a person when you view them as garbage, trash… a “junkie.” Stigma tells us, “Take out the trash.”

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To fully recognize stigma’s impact, compare addiction to other diseases. Consider common medical emergencies; many are related to lifestyle. Imagine being hospitalized after your third stroke, and the doctor telling you, “This is the third time I’ve saved your life, yet you refuse to exercise. I shouldn’t be obligated to continue to provide life-saving care.” Or, imagine a long-time smoker who develops lung cancer; they’re not demeaned, called names, or denied treatment. Moreover, an EMS worker wouldn’t withhold CPR from an individual in cardiac arrest if they were obese. It’s not a debate.

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If You’re Dead, You Have a 0% Chance of Recovery

We’re in the midst of an epidemic.

According to the CDC, 115 Americans die from an opioid overdose every day.

In 2016, over 42,000 individuals died from opioid overdose.

Life expectancy in America is actually declining due to an increase in fatal overdoses.

Narcan does not enable addiction. It enables life. (A dead addict can’t recover.)

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#Recovery #Empathy #FightStigma #EndTheEpedemic #SaveALife


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