12 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.

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) not refer to herself as “Dr. ____” when coordinating with outside agencies, as it often led to confusion. 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, and 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.

Characteristics of an Effective Clinical Supervisor

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 clinical 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 clinical 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 clinical 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 clinical 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 clinical 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 clinical 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.

Conclusion

In sum, the characteristics of an effective clinical supervisor include the following:

  1. Self-aware
  2. Practices regular self-care
  3. Provides constructive and specific feedback on an ongoing basis
  4. Supportive
  5. Asks thoughtful questions
  6. Discusses client cases as a teaching tool
  7. Empathetic
  8. Dedicated
  9. Avoids making assumptions
  10. Active listener
  11. Attentive
  12. Gatekeeper

clinical supervisor

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

40 Worst Comments About Mental Illness 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.

I turned to Quora (an online platform for asking questions) to see what people today are asking about mental illness. What I found ranged from thought-provoking to comical to disturbing, illustrating how common misconceptions are. Here are some of the worst comments and questions I came across:

woman sleeping
Photo by Ivan Oboleninov on Pexels.com

40 Worst Comments & Disturbing Posts About Mental Illness (on Quora)

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?”


worst comments

Please leave your thoughts/feedback in a comment!

500 Free Printable Workbooks & Manuals for Therapists

A list of over 500 free printable workbooks, manuals, toolkits, and guides for mental health professionals or self-help.

(Updated 10/25/25) The following list is comprised of links to over 500 free printable workbooks, manuals, toolkits, and guides that are published online and are 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.

Please repost this and/or share with anyone you think could benefit from these free printable workbooks and clinical tools!


For free printable workbooks and guides designed especially for youth/family, click here. For additional free printable workbooks and resources on a variety of mental health topics, see 200+ Sites with Free Therapy Worksheets & Handouts and 50 Free Mental Health Worksheets & Handouts.


Free Printable Workbooks, Manuals, & Self-Help Guides for Mental Health Professionals & Consumers

Disclaimer: Links are provided for informational and educational purposes. I recommend reviewing each resource before using for updated copyright protections that may have changed since it was posted here. When in doubt, contact the author(s).


Substance Use Disorders & Addiction

Free printable workbooks, manuals, toolkits/self-help guides for substance and behavioral (i.e., food, gambling, etc.) addictions and recovery


There are several SAMHSA workbooks listed below; you can find additional free publications on SAMHSA’s website. For fact sheets and brochures, go to the National Institute on Drug Abuse website or the National Institute on Alcohol Abuse and Alcoholism. If you’re looking for 12-step literature, many 12-step organizations post free reading materials, workbooks, and worksheets; don’t forget to check local chapters! (See 12-Step Recovery Groups for a comprehensive list of recovery support group sites.)

Other great places to look for free printable workbooks and resources for addiction include education/advocacy and professional membership organization sites. (Refer to the Resource Links page on this site for an extensive list.)


💜 = Resource for Veterans
🏳️‍🌈 = LGBTQ+ Resource

Anxiety & Mood Disorders

Free printable workbooks and other resources for anxiety (generalized, social phobia/anxiety, panic attacks), depressive and bipolar disorders, and prenatal/postpartum anxiety and depression


For more factsheets, brochures, and booklets, see SAMHSA, National Institute of Mental Health, NHS UK, CMHA, and education/advocacy sites listed on the Resource Links page on this site.


💜 = Resource for Veterans

Anxiety Disorders
Depressive & Bipolar Disorders
Postpartum Anxiety & Depression

Schizophrenia & Psychotic Disorders

A small collection of free printable workbooks, manuals, toolkits, and guides for schizophrenia spectrum and related disorders

Obsessive-Compulsive & Hoarding Disorders

Free printable workbooks, manuals, and guides for obsessive-compulsive, hoarding, and related disorders and issues

Trauma & PTSD

Free printable workbooks, manuals, and guides for trauma (including vicarious trauma) and PTSD

💜 = Resource for Veterans

Eating Disorders

Free printable workbooks and toolkits/guides for anorexia, bulimia, and binge eating disorders

Suicide & Self-Harm

Free printable workbooks and toolkits/guide for suicide prevention and recovery and for non-suicidal self-injury

For additional resources for suicide, see 100+ Resources for Suicide Prevention & Recovery.

Grief & Loss

Free printable workbooks and toolkits/guides for grief and loss

For additional resources for grief and loss, see Grief & Loss: A Comprehensive Resource Guide and 3 Powerful TED Talks on Grief.

Anger

Free printable workbooks, manuals, and guides for coping with anger

For additional anger management tools, see 75 Helpful Anger Management Resources.

Self-Esteem: Free Printable Workbooks & Guides

Healthy Relationships & Communication

For additional related tools, see 50 Free Marriage & Relationship Assessment Tools.

Meditation & Mindfulness

Resiliency, Personal Development, & Wellness

Free Printable Workbooks for Forgiveness
  • DIY Workbook Series from the Positive Psychology Research Group at Virginia Commonwealth University (All of the following workbooks can be accessed through this link)
    • The Path to Humility: Six Practical Sections for Becoming a More Humble Person (84 pages)
    • The Path to Forgiveness: Six Practical Sections for Becoming a More Forgiving Person
    • Your Path to REACH Forgiveness: Become a More Forgiving Person in Less Than Two Hours
    • Moving Forward: Six Steps to Forgiving Yourself and Breaking Free from the Past (70 pages)
    • Experiencing Forgiveness: Six Practical Sections for Becoming a More Forgiving Christian
    • The Path to Patience: Six Practical Sections for Becoming a More Patient Person
    • The Path to Positivity: Six Practical Sections for Becoming a More Positive Person
  • Moving Forward: Six Steps to Forgiving Yourself (Self-Directed Learning), 2nd Ed. | (Printable workbook) Source: Virginia Commonwealth University/ForgiveSelf.com, 69 pages) 2015
Free Printable Workbooks & Guides for Sleep
Free Printable Workbooks & Guides for Stress

Self-Care

Free printable workbooks, toolkits, and guides for self-care

Nutrition & Exercise

Free printable workbooks, manuals, and guides for diet, physical activity, and health


CBT, DBT, & MI

Note: The free printable workbooks and other resources listed in the following section may also be listed in other sections of this post.


CBT: Free Printable Workbooks & Manuals
DBT: Free Printable Workbooks & Manuals
Motivational Interviewing

Additional Free Printable Workbooks, Manuals, & Self-Help Guides

🔝

free printable PDF workbooks

Please comment with links to additional free printable workbooks and PDF resources for therapy or self-help!

4 Ways to Fight Stigma with Language

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

Have you ever been called a bitch? A creep? A whore? Have you received criticism that felt unfair or dismissive? Maybe someone’s words made you feel belittled or unappreciated. Language has the power to shape our experiences, and words become weapons when used to wound.

Consider the power of hearing your name spoken aloud. It instantly grabs your attention, pulling you into the present moment. You’re most likely going to respond or at least pause in what you’re doing.

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 can divide humanity. Retard. White trash. Crazy. Junkie. N*****. Slut. Spic.

Why Language Matters: 4 Words/Phrases to Stop Saying

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 “person with a substance use disorder.” Demonstrate the same empathy you would for a person who has cancer or MS or paralysis.

“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.

“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.”

“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.


Language has 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

Many believe that addiction is choice and that individuals who use drugs are just “junkies” – and #JunkieLivesDontMatter.

This article is inspired, in part, by an ignorant (not ill-intended) meme posted by a healthcare worker on social media.

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.”

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

Image by Pexels from Pixabay

If you believe it is 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 also a part of the movement: #JunkieLivesDontMatter

Image by SplitShire from Pixabay

Many have joined the movement, as evidenced by the following social media 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

Image by Myriams-Fotos from Pixabay

#JunkieLivesDontMatter: Addiction & Stigma

According to 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.

The 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… or a worthless junkie.

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.” #JunkieLivesDontMatter

Image by Hamed Mehrnik from Pixabay

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.

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.

Image by Simon Orlob from Pixabay

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

#Recovery #Empathy #FightStigma #EndTheEpedemic #SaveALife


If you live in Fairfax County (Virginia), sign up for a free REVIVE! Training!

#junkielivesdontmatter

25 Best Mental Health Blogs to Follow in 2020

(Updated 11/1/20) A list of 25+ mental health, wellness, and personal development blogs

(Updated 11/1/20) Creating Mind Remake Project opened my eyes to a whole world of blogs. There are tons of informative and thought-provoking mental health blogs out there on mental health and related topics.

This is a list of the best mental health blogs to follow in 2020 as well as helpful sites about wellness and personal development.

25 Best Mental Health Blogs to Follow in 2020

1. ACA Counseling Corner Blog | “Thoughtful ideas, suggestions, and strategies for helping you to live a happier and healthier life”

2. Aim Hypnotherapy & Counseling Blog | A blog by therapist Aigin Larki about anxiety, addiction, stress, and related topics

3. Anxiety Free World Blog | A mental health blog about coping with anxiety (by a writer with anxiety)

4. Brave Over Perfect | A blog about personal growth topics by Dr. Christine Carter and Susie Rinehart

5. Brené Brown Blog | A personal growth and development blog

6. David’s Blog | A pharmacology and mental health blog by Dr. David Healy, psychiatrist, psychopharmacologist, scientist, and author

7. David Susman, Ph.D. | A blog with resources and inspiration for better mental health by Dr. Susman, clinical psychologist, mental health advocate, professor

8. Dr. Melissa Welby | A blog about psychiatry and wellbeing by Harvard-trained psychiatrist, Dr. Welby

9. Dr. Sarah Ravin | A professional blog about psychological issues and evidence-based treatments by Dr. Ravin, a licensed psychologist

10. Everything Matters: Beyond Meds | An award-winning mental health blog on topics related to psychotropics and mental illness by Monica Cassani, ex-patient and mental health professional

11. Gardening Love | A unique wellness, ecotherapy, and lifestyle blog about enhancing mental health through gardening

12. Info Counselling: Evidence Based Therapy Techniques | A blog by a professional counselor with the latest evidence-based treatments and downloadable therapy worksheets

13. Love and Life Toolbox | An award-winning blog about relationships and emotional health by Lisa Brookes Kift, marriage and family therapist

14. Mindcology | A blog with mental health and self-help posts written by psychologists, counselors, and other mental health practitioners

15. The Mighty | “A digital health community created to empower and connect people facing health challenges and disabilities”

16. Momentus Institute Blog | A blog dedicated to building and repairing the social emotional health of children

17. MQ News and Blog | A blog about transforming mental health care through research

18. My Brain’s Not Broken | A blog about personal experience with mental illness and reducing stigma

19. NAMI Blog | An advocacy blog from the National Alliance on Mental Illness

20. Our Parent Place: Where Mental Health and Parenting Meet | A place for parents with mental illness to connect and learn

21. Psych Central Network Blogs | A list of mental health blogs by experts, professionals, and ordinary people who share their insights on a variety of mental health topics

22. Psychology Today Blogs | A large collection of blogs on psychology-related topics, including creativity, intelligence, memory, parenting, and more

23. SAMHSA Blog | “A place where up-to-date information including articles from SAMHSA staff, announcements of new programs, links to reports, grant opportunities, and ways to connect to other resources are located”

24. A Splintered Mind | A blog by Douglas Scootey about “overcoming ADHD and depression with lots of humor and attitude”

25. Thriving While Disabled | A blog about living with a disability

Additional Mental Health Blogs to Follow

Blunt Therapy | “Tips, advice, and analysis from a licensed therapist who’s been there”

Healthy Place Blogs | A page with links to other mental health blogs

Janaburson’s Blog | A blog created to help people better understand the medication-assisted treatment of opioid addiction using either buprenorphine (Suboxone) or methadone from a physician, board-certified in Internal Medicine and Addiction Medicine

Pete Earley | Advocacy blog for mental health reform

Your Brain Health | A blog about topics related to mental health and neurology by Dr. Sarah McKay, a neuroscientist


Know of any great mental health blogs not listed? Post in a comment!

mental health blogs

How to Help a Loved One with Addiction: 7 Tips that Promote Recovery

How to help a loved one with addiction (7 tips) and how to tell the difference between helping and enabling

When it comes to someone else’s alcohol or drug use, how can you tell the difference between helping and enabling, and how can you help a loved one with addiction?

In my work at a residential treatment center, I’ve worked with family members who inadvertently fueled their loved one’s addiction. They “helped” by bailing them out of jail, giving them money, etc., which only enabled the individual to continue to get high. It’s hard for family members to differentiate between behaviors that help versus enable.

If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity” or “to make possible, practical, or easy” (according to Merriam-Webster). When applied to substance use, it means a person in active addiction is provided with the means to continue to use.

Helping a person in active addiction means supporting their basic needs, such as food, water, shelter, and clothing. (If someone is in jail or treatment, their basic needs are met; therefore, bailing them out would be enabling.) Thinking in terms of “needs vs. wants” helps you to recognize enabling and therefore, to help a loved one with addiction.

When a parent has a son or daughter with an addiction, it’s especially difficult to make the distinction between helping and enabling. A parent’s natural inclination is to nurture and protect from harm. It’s heart-wrenching to see your child in pain. But if a parent doesn’t set (and adhere to) healthy boundaries, they will quickly become emotionally drained (as they enable their child’s addiction).

Here are some ways to help a loved one with addiction who’s actively using:

1. Never (ever) offer money.

If asked for cash for food, for example, buy groceries instead (or offer to take them to lunch). I worked with a father who bought a bag of groceries for his son, who struggled with severe alcoholism and was homeless, on a weekly basis. This is an excellent example of how to help a loved one with addiction versus enabling their drug use.

2. If asked for help paying bills, say no. 

If your loved one doesn’t have to pay the electric bill, they’ll probably spend that money on drugs or alcohol. Furthermore, if you protect them from the consequences of not paying bills (i.e. having the power shut off), your loved one is less likely to see a need for change. (People don’t change when they’re comfortable.)

3. If your loved one is addicted to opioids (heroin, morphine, hydrocodone, etc.), attend a training or take an online course on opioid overdose reversal (Narcan [naloxone] administration).

If you’re unsure where local trainings are offered, a Google search for “Narcan training” or “opioid reversal training” will link you to resources in your area. Most trainings are free. Keep a Narcan kit on your person at all times. Provide your loved one with a kit (or two) as well.

This is not enabling. Help a loved one with addiction by potentially saving their life, thereby giving them the opportunity to recover. (A dead opioid-user doesn’t recover.)

4. Offer to help them get into treatment.

Become familiar with the different treatment options in your area. Don’t give ultimatums (i.e. “If you don’t get treatment, I’ll divorce you”) or make threats (especially if you’re not willing to follow through).

Be supportive, not judgmental. Be patient; when your loved one is emotionally and physically drained from addiction’s painful consequences (or when they hit “rock bottom”), they may decide it’s time to get help. And you’ll be ready.

5. Recognize that your loved one is not the same person they were before addiction.

Substance use disorder is a debilitating disease that damages the brain; it changes how a person feels and thinks. With addiction, the brain’s reward center is rewired, resulting in a biological “need” for drugs/alcohol. (Compare this to your need for food or water or air.)

Recognize that your loved one’s addiction will lie to you. They will do whatever it takes to get their “needs” met. Your loved one’s addiction will steal from you. (Lock up your valuables if they have access to your home… and even if they don’t. I’ve worked with more than a few individuals who have broken into their parents’ home for either money for drugs or valuables to pawn for money for drugs.)

Your loved one’s addiction will betray you. Accepting the nature of addiction will help you to set healthy boundaries.

6. Attend Al-Anon or Nar-Anon meetings.

By engaging with others with similar struggles, you’ll learn more about supporting your loved one (without enabling their addiction). You’ll also build a supportive network by connecting with others, strengthening your emotional health.

7. When in doubt, try asking yourself one (or all) of the following questions:

  • Will my actions help my loved one to continue to drink or use?
  • Is this a “want” or a basic need?
  • Will my actions prevent them from experiencing a natural consequence?

Conclusion

Addiction is a devastating, but treatable, disease. The road to recovery is difficult and long (with many detours).

While you can never control someone else’s behaviors, there are ways to help a loved one with addiction. Be kind and compassionate; they’re in an unthinkable amount of pain. They didn’t choose addiction. The best way to support them is by setting healthy boundaries to ensure you’re not enabling continued use.

Boundaries allow you to help them without furthering their addiction. Boundaries also serve as protection for you and your emotional health; you’re in no position to help if you’re emotionally, financially, and spiritually depleted.


Please share in a comment your suggestions for helping a loved one with addiction.

help a loved one with addiction

500 Free Online Assessment & Screening Tools

A list of over 500 free online assessment and screening tools for mental health professionals or self-help.

As of 3/10/25, this page is archived and will no longer be updated due to broken links. Please see the newest version: 200 Free Online (& PDF) Screening & Assessment Tools for Adults – mind remake project

This is a list of over 500 free online assessment screenings for clinical use and for self-help purposes. While an assessment cannot take the place of a diagnosis, it can give you a better idea if what you’re experiencing is “normal.”

Image by GuHyeok Jeong from Pixabay

For additional online assessment tools to use with couples, see Free Marriage & Relationship Assessment Tools.


500 Free Online Assessment & Screening Tools


Addiction & Substance Use Disorders

PDF and interactive online assessment tools for substance use disorders and other addictions


Anxiety & Mood Disorders

PDF and interactive online assessment tools for anxiety, depression, and bipolar disorders


Trauma, Stress, & Related Disorders Online Assessment Tools


Obsessive-Compulsive & Related Disorders Online Assessment Tools


Online Assessment Tools for Eating Disorders


Online Assessment Tools for Personality Disorders


Boundaries & Attachment Styles


Relationships & Communication


For additional relationship and communication assessments, see Free Marriage & Relationship Assessment Tools.


Anger


For additional online assessment tools and resources, see Resources for Anger Management.


Violence & Sexual Assault


Suicide Risk & Self-Injury

  • Columbia-Suicide Severity Rating Scale | PDF scale
  • Deliberate Self-Harm Inventory | Measurement of deliberate self-harm (PDF)
  • Imminent Risk and Action Plan | Assessment/plan (Source: University of Washington Center for Behavioral Technology)
  • Lifetime – Suicide Attempt Self-Injury Count (L-SASI) Instructions Scoring | The L-SASI is an interview to obtain a detailed lifetime history of non-suicidal self-injury and suicidal behavior. Citation: Linehan, M. M. &, Comtois, K. (1996). Lifetime Parasuicide History. University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Lineham Risk Assessment and Management Protocol | Citation: Linehan, M. M. (2009). University of Washington Risk Assessment Action Protocol: UWRAMP, University of WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Non-Suicidal Self-Injury Assessment Tool Brief Version | Full Version | Assessment tool (Source: Cornell Research Program on Self-Injury and Recovery)
  • NSSI Measures Archives | A collection of instruments for self-harm (Source: International Society for the Study of Self-Injury)
  • NSSI Severity Assessment | A PDF assessment tool to assess the severity of non-suicidal self-injury (Source: Cornell Research Program on Self-Injury and Recovery)
  • Reasons for Living Scale Scoring Instructions | RFL Scale (long form – 72 items) | RFL Scale (short form – 48 items) | RFL Scale (Portuguese) | RFL Scale (Romanian) | RFL Scale (Simplified Chinese) | RFL Scale (Traditional Chinese) | RFL Scale (Thai) | The RFL is a self-report questionnaire that measures clients’ expectancies about the consequences of living versus killing oneself and assesses the importance of various reasons for living. The measure has six subscales: Survival and Coping Beliefs, Responsibility to Family, Child-Related Concerns, Fear of Suicide, Fear of Social Disapproval, and Moral Objections. Citation: Linehan M. M., Goodstein J. L., Nielsen S. L., & Chiles J. A. (1983). Reasons for staying alive when you are thinking of killing yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology, 51, 276-286. (Source: University of Washington Center for Behavioral Technology)
  • Self-Injury Questionnaire | To assess self-harm (PDF, assessment in appendix)
  • Suicidal Behaviors Questionnaire | SBQ with Variable Labels | SBQ Scoring Syntax | The SBQ is a self-report questionnaire designed to assess suicidal ideation, suicide expectancies, suicide threats and communications, and suicidal behavior. Citation: Addis, M. & Linehan, M. M. (1989). Predicting suicidal behavior: Psychometric properties of the Suicidal Behaviors Questionnaire. Poster presented at the Annual Meeting of the Association for the Advancement Behavior Therapy, Washington, DC. (Source: University of Washington Center for Behavioral Technology)
  • Suicide Attempt Self-Injury Interview (SASII) SASII Instructions For Published SASII | SASII Standard Short Form with Supplemental Questions | SASII Short Form with Variable Labels | SASII Scoring Syntax | Detailed Explanation of SPSS Scoring Syntax | The SASII (formerly the PHI) is an interview to collect details of the topography, intent, medical severity, social context, precipitating and concurrent events, and outcomes of non-suicidal self-injury and suicidal behavior during a target time period. Major SASII outcome variables are the frequency of self-injurious and suicidal behaviors, the medical risk of such behaviors, suicide intent, a risk/rescue score, instrumental intent, and impulsiveness. Citation: Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18(3), 303-312. (Source: University of Washington Center for Behavioral Technology)
  • Ask Suicide-Screening Questions (ASQ) Toolkit | Source: National Institute of Mental Health
  • University of WA Suicide Risk/Distress Assessment Protocol | Citations: Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006). Risky assessments: Participant suicidality and distress associated with research assessments in a treatment study of suicidal behavior. Suicide and Life-Threatening Behavior, (36)1, 19-33. Linehan, M. M., Comtois, K. A., &, Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232. (Source: University of Washington Center for Behavioral Technology)

For additional resources for suicide risk, see Resources for Suicide Prevention & Recovery.


Self-Esteem & Self-Compassion


Online Assessment Tools for Personality & Temperament


Emotional Intelligence


Health & Wellness

PDF and interactive online assessment tools for happiness, resiliency, exercise, sleep, nutrition, and other health/wellness topics


Additional Online Assessment & Screening Tools

PDF and interactive online assessment tools for various topics related to mental health, addiction, and other topics

  • Abnormal Involuntary Movement Scale | 2-page PDF (Source: UMASS Medical School) (1998)
  • Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | A 3-page PDF with scoring instructions (Source: UMASS Medical School/ADD.org)
  • Affect Intensity Measure (AIM) | 40-question and 20-question PDF versions of the assessment (Citation: Larsen, R. J. (1984). Theory and measurement of affect intensity as an individual difference characteristic. Dissertation Abstracts International, 85, 2297B.)
  • APA Online Assessment Measures | PDF screening tools (Source: American Psychiatric Association)
  • Behavioral Tests | A collection of psychiatric assessments (Source: Lamar Soutter Library)
  • Brief Fear of Negative Evaluation Scale (BFNE) | 1-page PDF that can be completed online or printed, scoring instructions not included
  • Brief Psychiatric Rating Scale (BPRS) | 1-page PDF (Source: Psychiatric Times)
  • Buss Lab Research Instruments | Assessments for friendship, sex, jealousy, etc. (Source: Buss Lab)
  • Career Assessments | Self-assessments to assess interests, skills, and work values
  • Clance Impostor Syndrome Scale | 3-page PDF, includes scoring information (Source: The Impostor Phenomenon: When Success Makes You Feel Like A Fake (pp. 20-22), by P.R. Clance, 1985, Toronto: Bantam Books.)
  • Communication Research Measures | Source: James McCroskey, West Virginia University
  • CSDS DP Infant-Toddler Checklist | A PDF printable checklist for identifying early warning signs of autism
  • DBT-WCCL Scale and Scoring | Citation: Neacsiu, A. D., Rizvi, S. L., Vitaliano, P. P., Lynch, T. R., & Linehan, M. M. (2010). The Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL).: Development and psychometric properties. Journal of Clinical Psychology, 66(61), 1-20. (Source: University of Washington Center for Behavioral Technology)
  • Decision Making Individual Differences Inventory
  • The Defeat Scale (D Scale) | 2-page PDF (Source: The Compassionate Mind Foundation)
  • Demographic Data Scale | A self-report questionnaire used to gather extensive demographic information from the client. Citation: Linehan, M. M. (1982). Demographic Data Schedule (DDS). University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Diary Cards NIMH S-DBT Diary Card NIDA Diary Card CARES Diary Card | Source: University of Washington Center for Behavioral Technology
  • Division 12 Assessment Repository | Source: Society of Clinical Psychology
  • EAP Lifestyle Management Self-Assessments | A small collection of screening tools
  • Emotional Regulation Questionnaire (ERQ) | A short PDF scale to assess emotional regulation
  • The Entrapment Scale | 2-page PDF with scoring information, 1998 (Source: The Compassionate Mind Foundation)
  • Family Accommodation Scale – Anxiety | Family Accommodation Scale – Anxiety (Child Report) | PDF scales, scoring instructions not included
  • Financial Well-Being Questionnaire | Take this 10-question interactive test and receive a score (along with helpful financial tips)
  • Focus on Emotions | PDF assessment instruments for children and adolescents from 9 to 15 years. Includes Empathy Questionnaire (EmQue), Mood List, Alexithymia Questionnaire for Children, Emotion Awareness Questionnaire (EAQ), BARQ, Behavioral Anger Response Questionnaire, Worry / Rumination, Somatic Complaint List, Instrument for Reactive and Proactive Aggression (IRPA) Self-Report, Brief Shame and Guilt Questionnaire for Children, Coping Scale, and Social-Emotional Development Tasks
  • Grief and Loss Quiz | Interactive quiz (Source: PsychCentral)
  • Guilt and Shame Proneness scale (GASP) | 4-page PDF with scoring information, 2011 (Source: Taya R. Cohen)
  • HealthyPlace Psychological Tests | Interactive tests for abuse, anxiety, depression, personality disorders, and more (Source: HealthyPlace)
  • Helpful Questionnaires | Topics are varied (Source: James W. Pennebaker/University of Texas at Austin)
  • IDR Labs Tests | Interactive psychology tests
  • Integrated Biopsychosocial Assessment Form | 16-page PDF assessment form
  • Intellectual Humility Quiz | Online interactive test (Source: Greater Good Magazine) 🆕
  • Internalized Stigma of Mental Illness Inventory (ISMI) | 2-page PDF (Source: J. Ritsher, University of California, San Francisco)
  • Library of Scales | 25 psychiatric scales (PDF documents) to be used by mental health practitioners in clinical practice. Includes Frequency, Intensity, and Burden of Side Effects Ratings; Fagerstrom Test for Nicotine Dependence; Fear Questionnaire; Massachusetts General Hospital Hair Pulling Scale; and more. (Note: Some of the assessments have copyright restrictions for use.) (Source: Outcome Tracker)
  • Measurement Instrument Database for the Social Sciences | A searchable database (Source: MIDSS)
  • Measures and Scales | Source: University of Utah Psychology Faculty
  • Mental Health Screening Tools | Online screenings for depression, anxiety, bipolar, psychosis, eating disorders, PTSD, and addiction. You can also take a parent test (for a parent to assess their child’s symptoms), a youth test (for a youth to report his/her symptoms), or a workplace health test. The site includes resources and self-help tools.
  • Military Health System Assessments | Interactive tests for PTSD, alcohol/drug use, relationships, depression, sleep, anxiety, anger, and stress
  • Mind Diagnostics
  • Mindset Assessment: What’s My Mindset? | Online interactive test, requires email sign-up to view results (Source: Mindsetworks) 🆕
  • Modified Checklist for Autism in Toddlers, Revised, with Follow-Up | Free download and scoring instructions
  • The Multidimensional Experiential Avoidance Questionnaire (MEAQ) | 3-page PDF with scoring information, 2011 (Citation: Gamez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (in press). Development of a measure of experiential avoidance: The Multidimensional Experiential Avoidance Questionnaire (MEAQ), Psychological Assessment.)
  • Open Source Psychometrics Project | This site provides a collection of interactive personality and other tests, including the Open Extended Jungian Type Scales, the Evaluations of Attractiveness Scales, and the Rosenberg Self-Esteem Scale.
  • Other as Shamer Scale (OAS) | 2-page PDF with scoring information, 1994 (Source: The Compassionate Mind Foundation)
  • Parental Affect Test | The Linehan Parental Affect Test is a self-report questionnaire that assesses parent responses to typical child behaviors. Citation: Linehan, M. M., Paul, E., & Egan, K. J. (1983). The Parental Affect Test – Development, validity and reliability. Journal of Clinical Child Psychology, 12, 161-166. (Source: University of Washington Center for Behavioral Technology)
  • Patient Health Questionnaire Screeners | This is a great diagnostic tool for clinicians. Use the drop down arrow to choose a PHQ or GAD screener (which assesses mood, anxiety, eating, sleep, and somatic concerns). The site generates a PDF printable; you can also access the instruction manual. No permission is required to reproduce, translate, display or distribute the screeners.
  • Project Implicit | A variety of interactive assessments that measures your hidden biases
  • Project Teach Rating Scales | PDF assessments for children and youth
  • Psychological Self-Tests and Quizzes | Interactive tests (Source: Counselling Resource)
  • Psychologist World Personality & Psychology Tests | Interactive tests
  • Psychology Scales | Topics are varied, including likability, honesty, expertise, etc.) (Source: Stephen Reysen)
  • Psychology Tools | Online self-assessments for addiction, ADHD, aggression, anxiety, autism spectrum, bipolar, depression, eating disorders, OCD, and personality.
  • PsychTests | Interactive tests for intelligence, personality, career, health, relationships, and lifestyle & attitude
  • PsychTools | Searchable database
  • Psymed Psychological Tests | Interactive tests for addiction, anxiety, mood disorders, personality disorders, and more
  • Questioning Reality Self-Check | Interactive questionnaire (Source: Foundry)
  • Recovery Assessment Scales | A variety of assessments for individuals recovering from psychiatric illnesses
  • Research-Based Psychological Tests | Questionnaires for anxiety, depression, personality, etc. (Source: Excel At Life)
  • Revised Beliefs About Voices Questionnaire (BAVQ-R) | Citation: CHADWICK, P., LEES, S., & BIRCHWOOD, M. (2000). The British Journal of Psychiatry, 177, 229-232.
  • Ruminitive Responses Scale | 1-page PDF (Source: Treynor, Gonzalez, and Nolen-Hoeksema, 2003)
  • Self-Assessment Checklist for Personnel Providing Behavioral Health Services and Supports to Children, Youth and their Families | 4-page PDF (Source: Tawara D. Goode, National Center for Cultural Competence) (1989, revised 2009)
  • Scales | 3 assessments available (Need for Closure, Locomotion, and Assessment) (Source: Motivated Cognition Lab
  • Science of Behavior Change Measures | Assessments for stress, communication, relationships, emotional regulation, and more
  • Screening Tools – Autism Canada | Interactive screening tools for autism for toddlers, children, teens, and adults (Source: Autism Canada) 🆕
  • Sensitivity Test for Adults | A carefully designed questionnaire to measure sensitivity in adults. (There is also a version for children.) 🆕
  • The Shame Inventory | 3-page PDF (Citation: Rizvi, S. L. (2010). Development and preliminary validation of a new measure to assess shame: The Shame Inventory. Journal of Psychopathology and Behavioral Assessment, 32(3), 438-447.)
  • Social History Interview (SHI) | The SHI is an interview to gather information about a client’s significant life events over a desired period of time. The SHI was developed by adapting and modifying the psychosocial functioning portion of both the Social Adjustment Scale-Self Report (SAS-SR) and the Longitudinal Interview Follow-up Evaluation Base Schedule (LIFE) to assess a variety of events (e.g., jobs, moves, relationship endings, jail) during the target timeframe. Using the LIFE, functioning is rated in each of 10 areas (e.g., work, household, social interpersonal relations, global social adjustment) for the worst week in each of the preceding four months and for the best week overall. Self-report ratings using the SAS-SR are used to corroborate interview ratings. Citations: Weissman, M. M., & Bothwell, S. (1976). Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 1111-1115. Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E. C., Endicott, J., McDonald-Scott, P., & Andreasen, N. C. (1987). The longitudinal interval follow-up evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540-548. (Source: University of Washington Center for Behavioral Technology)
  • Somatoform Dissociation Questionnaire | A PDF assessment, scoring information here
  • Soul Shepherding Assessments | Assess for emotional intelligence, life stress events, and stress overload (3 PDF assessments)
  • Stanford Medicine WellMD | Self-tests for altruism, anxiety, burnout, depression, emotional intelligence, empathy, happiness, mindfulness, physical fitness, PTSD, relationship trust, self-compassion, sleepiness, stress, substance use, and work-life balance
  • Supervisory Relationship Questionnaire (SRQ) | PDF scale with scoring instructions
  • Survey Instruments and Scales | To assess risky sexual behaviors (Source: CAPS)
  • Therapist Interview | The TI is an interview to gather information from a therapist about their treatment for a specific client. Citation: Linehan, M. M. (1987). Therapist Interview. University of Washington, Seattle, WA, Unpublished work. (Source: University of Washington Center for Behavioral Technology)
  • Treatment History Interview | Appendices | The THI is an interview to gather detailed information about a client’s psychiatric and medical treatment over a desired period of time. Citation: Linehan, M. M. &, Heard, H. L. (1987). Treatment history interview (THI). University of Washington, Seattle, WA, Unpublished work. Therapy and Risk Notes – do not use without citation. For clarity of how to implement these items, please see Cognitive-Behavioral Treatment of Borderline Personality Book, Chapter 15. (Source: University of Washington Center for Behavioral Technology)
  • TTM Measures | To assess for self-efficacy, decision-making, process of change, etc. (Source: HABITS Lab)
  • Voice Hearing: A Questionnaire | 17-page PDF questionnaire for hearing voices (Source: South Bay Project Resource)
  • Whirlwind of Psychological Tests | A modest collection of tools (Source: Delroy L. Paulhus)
  • Why Do You Lie? | Interactive quiz (Source: WebMD)

online assessment

If you know of a free assessment for mental health or addiction that’s not listed here, please share in a comment! Contact me if a link is not working.

4 Strategies for Better Decision-Making

People with “big picture” styles of reasoning make better decisions. Learn 4 strategies for “big picture” thinking for better decision-making.

A recent study found that a “big picture” style of thinking led to better decision-making. (“Better” decisions were defined as those resulting in maximum benefits.)

If ever you took the Myers-Briggs (a personality assessment), and fell on the “Intuition” side of the spectrum (like me!), it’s likely you’re already a “big picture” thinker. If you’re on the “Sensing” side, you’re more apt to examine individual facts before considering the sum of all parts when decision-making.

“Big picture” thinking is a practical and balanced method of reasoning. It suggests taking a step back (zoom out!)… and looking to see how all pieces fit together for more effective decision-making.

The following strategies promote “big picture” thinking for better decision-making:

1. Get a good night’s rest

Researchers from the Beth Israel Deaconess Medical Center found that sleep is essential for “relational memory” (or the ability to make inferences, i.e. “big picture” thinking) for good decision-making.

Before making a tough decision, sleep on it; you’ll wake up with a new perspective! In addition to healthy sleep hygiene, the following strategies have been found to improve sleep:

2. Don’t deliberate for long

Research indicates that when weighing out options, it’s ideal to take small breaks. For more effective decision-making, don’t deliberate for long periods of time or you’ll start to lose focus. If things become fuzzy, you won’t see the big picture.

3. Bay day = bad decision

One study found that a positive mood is related to a “big picture” thinking style. Good moods are associated with broader and more flexible thinking. A positive mood enables someone to step back emotionally, psychologically distancing themselves from the decision at hand.

If you’re feeling salty, hold off decision-making. Instead, try one (or all!) of the following research-based techniques for boosting your mood:

4. Get a second opinion

Ask around to learn how others’ view your situation. Every perspective you collect is another piece of the “big picture” puzzle.

Seek opinions from those you trust (only those who have your best interests in mind). Make sure you ask a variety of people (especially those with whom you typically disagree). The end result is a broader and more comprehensive awareness of what you’re facing.


Employ all four strategies to optimize your thinking style and decision-making skills!

decision-making

  • References
  • American Academy of Sleep Medicine. (2010, April 4). Maintaining regular daily routines is associated with better sleep quality in older adults. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2010/04/100401085336.htm
  • American Academy of Sleep Medicine. (2008, June 12). Moderate Exercise Can Improve Sleep Quality Of Insomnia Patients. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2008/06/080611071129.htm
  • American Chemical Society (ACS). (2012, August 19). Good mood foods: Some flavors in some foods resemble a prescription mood stabilizer. ScienceDaily. Retrieved July 10, 2018 from http://www.sciencedaily.com/releases/2012/08/120819153457.htm
  • American Psychological Association. (2018, April 23). Let it go: Mental breaks after work improve sleep: Repetitive thoughts on rude behavior at work results in insomnia. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2018/04/180423110828.htm
  • Baycrest Centre for Geriatric Care. (2012, May 14). A walk in the park gives mental boost to people with depression. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2012/05/120514134303.htm
  • Berman, M. G., Kross, E., Krpan, K. M., Askren, M. K., Burson, A., Deldin, P. J., Kaplan, S., Sherdell, L., Gotlib, I. H., & Jonides, J. (2012). Interacting with nature improves cognition and affect for individuals with depression. Journal of Affective Disorders, DOI: 10.1016/j.jad.2012.03.012
  • Beth Israel Deaconess Medical Center. (2007, April 21). To Understand The Big Picture, Give It Time – And Sleep. ScienceDaily. Retrieved June 17, 2018 from http://www.sciencedaily.com/releases/2007/04/070420104732.htm
  • Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances. JAMA Internal Medicine, DOI: 10.1001/jamainternmed.2014.8081
  • Curry, O., Rowland, L., Zlotowitz, S., McAlaney, J., & Whitehouse, H. (2016). Happy to help? A systematic review and meta-analysis of the effects of performing acts of kindness on the well-being of the actor. Open Science Framework
  • Demsky, C. A. et al. (2018). Workplace incivility and employee sleep: The role of rumination and recovery experiences. Journal of Occupational Health Psychology, DOI: 10.1037/ocp0000116
  • The JAMA Network Journals. (2015, February 16). Mindfulness meditation appears to help improve sleep quality. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2015/02/150216131115.htm
  • Labroo, A., Patrick, V., & Deighton, J. served as editor and Luce, M. F. served as associate editor for this article. (2009). Psychological distancing: Why happiness helps you see the big picture. Journal of Consumer Research, 35(5), 800-809. DOI: 10.1086/593683
  • Northwestern University. (2017, July 10). Purpose in life by day linked to better sleep at night: Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2017/07/170710091734.htm
  • Ohio State University. (2018, July 13). How looking at the big picture can lead to better decisions. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2018/07/180713111931.htm
  • Spira, A. P. (2015). Being mindful of later-life sleep quality and its potential role in prevention. JAMA Internal Medicine, DOI: 10.1001/jamainternmed.2014.8093
  • Stillman, P. E., Fujita, K., Sheldon, O., & Trope, Y. (2018). From “me” to “we”: The role of construal level in promoting maximized joint outcomes. Organizational Behavior and Human Decision Processes, 147(16), DOI: 10.1016/j.obhdp.2018.05.004
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3 Reasons We Keep Toxic People in Our Lives

Why do we keep toxic people in our lives? Despite the emotional costs, many people chose to remain in toxic relationships. This post explores the emotional reasoning behind not letting go.

Recently, an acquaintance told me about breaking up with his girlfriend, a toxic person for him. His story made me cringe and left me wondering, how on earth did it get to that point? Why do we allow toxic people to remain in our lives?

For my friend, it began when his at-the-time girlfriend covertly moved in with him; initial casual sleepovers morphed into a permanent presence. As weeks turned into months, it became apparent she had some serious mental health issues. The relationship deteriorated, and my friend was ready to reclaim his space.

So, he ended things between them and told her to get out. And… she refused. This is also when he found out she was homeless.

He kicked her out of the bedroom; she started sleeping on the couch. My friend resorted to tactics like removing her phone and parking pass. Despite his efforts, she continued to live (rent-free) on his couch.

To make a long story short… she eventually left… but not until the apartment manager and police got involved.

My friend’s story, while unique, is a stark reminder of how difficult it can be to escape the clutches of a toxic person, even when the signs are glaringly clear. The reality is, it’s never as simple as “it’s over, get out.” Breaking free from a toxic relationship is rarely a clean break.

3 Reasons We Keep Toxic People in Our Lives

What are the reasons we allow toxic people (friends, family, and/or romantic partners) to remain in our lives? Why is it so hard to let go?

1. Either You Need Them (or You Can’t Ignore Them)

A recent study suggests we keep toxic people around simply because their lives are intertwined with ours. For example, your aging mother-in-law, who degrades and insults you, lives at your home, despite the negative impact this has on your life. Your options are limited because your husband is unwilling to put her in a nursing home (and you may also depend on her for things, like childcare or help with the bills).

Another example would be toxic people at work (coworkers, bosses, subordinates, etc.); you don’t have a lot of choice when it comes to your boss or colleagues, and you can’t entirely avoid them or refuse to talk about work-related stuff (unless you’re okay with losing your job). If pursing a new position isn’t practical, your next best option is to find a way to effectively deal with workplace toxicity.

That said, you don’t have the power to change anyone else. To manage your reactions to and interactions with toxic people, acknowledge the need for self-adjustment, including attitude and role. Examine your personal views. Lower/manage expectations for others; accept that people will do and say things you don’t agree with… and it’s not something you can control.

Once you’ve reached the point of radical acceptance, follow guidelines for effective communication (i.e., active listening, avoiding blame, being aware of tone and body language, reflecting for clarity, etc.) in conversations with toxic people, whether it’s your mother-in-law or your boss. By being proactive, you’re doing your part to avoid getting caught up in others’ toxicity.

In the face of unavoidable toxicity, I find switching to a “counselor role” is helpful; I set aside my personal viewpoint, opening myself to alternative views, while seeking to understand (not judge) behavior. (And you don’t have to be a counselor to do this!)

I try to view individuals in terms of “what happened to you?” instead of assuming they’re malicious or intentional (i.e., “what’s wrong with you? People act the way they do for a reason). I don’t know what’s happening in a “toxic” person’s life or what they’ve been through.

Maybe that snarky co-worker is in an abusive relationship and lives in fear. Or maybe her son is in the hospital with brain cancer. Or it’s possible she grew up in a home where her parents yelled and disrespected each other, shaping her view of relationships. The snarky attitude makes sense when viewed through different lenses.

While it’s never okay to be an asshole, I can understand why people are jerks. Somehow, this knowledge serves as an immunity when encountering a toxic person. Their behavior is the result of something bad that happened to them; it has nothing to do with me and I can choose whether or not to engage. They don’t have power to negatively impact me unless I give it up.

2. Toxic Love: It Feels Better to Stay

When Joe Strummer of the Clash sang the question, “Should I stay or should I go now?”; he already knew the answer. We stay in unhealthy relationships or continue to hang out with toxic friends because it feels good (at times, at least).

The boyfriend who yells at you can also be incredibly sweet and caring. Or your gossipy friend who talks about you behind your back also happens to be the most fun person you know. Despite the sense that it’s unhealthy, you (like Strummer) can’t resist. So, you ignore the red flags because you crave the rush or the intensity… or maybe what you desire most is the feeling of being wanted. (Despite the toxicity, it’s worth it, just to feel wanted… or is it?)

Beyond feeling good, it’s entirely possible to deeply love a toxic person (no matter how wrong they are for you). You don’t want to give up on the person they could be; maybe you’re in love with their potential (or an idea of what the relationship could be). You believe it’s better to sacrifice your happiness (your dignity, your well-being, your independence) than to be without the person you love.

On the flip side, some people stay in toxic relationships because deep down, they believe they can’t do any better and/or the abuse is a preferable alternative to being alone. It could also mean they believe they deserve to be punished (which sometimes happens when a person remains in an abusive relationship for a long time). Or they may reason that it’s better to hang out with a “mean girl” than sit and stare at the walls on a Friday night.

If you can relate to staying in a toxic relationship because it feels good or are afraid of being alone, carefully consider and weigh out the long-term costs of a toxic relationship. There are far worse and more damaging things than being alone.

If the idea of being alone terrifies you, maybe it’s an indication that something’s not right… that you’re not okay. It could be a sign of low self-worth or could point to an intense fear of abandonment. It may also signify a lack of understanding of what it means to be in a healthy relationship. Lastly, an intense fear of being alone is associated with some of the personality disorders and/or could be the result of trauma.

3. It’s (So Much) Easier to Stay

Breaking up is messy and uncomfortable. In my experience, most people avoid conflict whenever possible. Despite the fact that conflict is a natural, everyday occurrence, it can feel unpleasant, even for those with expert conflict resolution skills.

In relationships, avoiding conflict does more harm than good. In a healthy relationship, it’s necessary to address problems in order to resolve them, thereby strengthening the relationship.

In a toxic relationship, conflict should not be avoided, but for different reasons. It may be easier to ignore the reality of your situation than to get honest, but this is detrimental (not only to you, but to your partner, who will never have the opportunity to change so long as you enable the toxicity to continue).

You may wish to avoid the emotional drain that accompanies confrontation, but in the long run, you’ll lose more emotional energy if you remain in a toxic relationship. (A steep, one-time payment is preferable to the ongoing, daily emotional sacrifices/abuses associated with toxicity; you’re slowly poisoned as time goes on.)

If you choose to end a toxic relationship, be realistic; it’s not going to be easy… and it’s going to hurt. A lot. You may love this person a great deal (and maybe you’ve long held on to the hope they’d change). Go into it with low (or no) expectations.

When things feel unbearable, remember that the easy things in life matter little; the difficult stuff is what leads to personal growth, success, and resilience.

Conclusion

In closing, I’m sure there are multitudes of reasons people have for staying in unhealthy relationships and keeping toxic people in their lives; this post is by no means comprehensive. I’m also certain, whatever the reason, it seems justifiable to them.

People don’t choose toxicity without some sort of justification (if not for others, then at least for themselves). Unfortunately, rationalizations don’t offer protection from harm. No matter the reason for remaining in a toxic relationship, it’s not worth the cost.


What are some other reasons people keep toxic people in their lives? Why is letting go so hard? Share your thoughts in a comment!

toxic people

  • References
  • Bar-Ilan University. (2018, January 17). Why we keep difficult people in our lives. ScienceDaily. Retrieved July 14, 2018 from http://www.sciencedaily.com/releases/2018/01/180117152513.htm
  • Offer, S., & Fischer, C.S. (2017). Difficult people: Who is perceived to be demanding in personal networks and why are they there? American Sociological Review, 000312241773795, DOI: 10.1177/0003122417737951