A list of recommended reads, including workbooks and textbooks, for mental health professionals
Compiled by Cassie Jewell, M.Ed., LPC, LSATP
Disclaimer: This post contains affiliate links. As an Amazon Associate I earn from qualifying purchases.
This is a recommended reading list for mental health clinicians. The first section includes recommendations for both professionals and consumers. The next section includes suggested workbooks for therapy and/or self-help. The “Textbooks” section is comprised of required reading that I found valuable as a counseling grad student. In the “PracticePlanners Series” section, I included the planners I’ve relied on the most. The last section includes additional reads that have been helpful to me in both my professional and personal life.
A resource guide for clinicians who facilitate counseling groups
By Cassie Jewell, M.Ed., LPC, LSATP
Throughout my counseling career, group therapy has been a focal part of what I do. I’ve worked mainly in residential settings where groups take place several times a day.
Initially, group counseling terrified me. (What if I can’t “control” the group? What if a member challenges me? What if I can’t think of anything to say? What if everyone gets up and leaves? – that actually happened, once – and on and on. What made group therapy especially intimidating was that if I “messed up,” an entire group of people [as opposed to one person] would witness my failure.)
I got over it, of course. Group facilitation wasn’t always comfortable and I made many (many!) mistakes, but I grew. I realized it’s okay to be both counselor and human; at times, humans say dumb stuff, hurt each other’s feelings, and don’t know the answer. By letting go of the need to be perfect, I became more effective. Group facilitation is now one of my favorite parts of the job.
This resource guide provides practical information and tools for group therapy for mental health practitioners.
Group Therapy Guidelines
Group therapy is an evidence-based treatment for substance use and mental disorders. An effective group calls for a skilled clinician to meet treatment standards. Professional associations, such as the American Group Psychotherapy Association, develop best practice guidelines based on scientific data and clinical research.
SAMHSA promotes research-based protocols and has published several group therapy guides for best practice, including TIP 41: Substance Abuse Treatment: Group Therapy, Substance Abuse Treatment: Group Therapy – Quick Guide for Clinicians, and Substance Abuse Treatment: Group Therapy Inservice Training (a training manual), in addition to group workbooks/facilitator guides for anger management, stimulant use disorder, and serious mental illness.
The book itself is small in size but packed with helpful information and creative ideas. As a new counselor lacking in clinical skills, I supplemented with activities to engage the clients. Group Exercises for Addiction Counseling never failed me.
A more recent discovery of mine. This guide provides detailed instructions accompanied by thought-provoking discussion questions for each intervention. I was impressed with both the quality and originality; an instant upgrade to “house-tree-person.”
You need only Google “icebreakers” and you’ll have a million to choose from. I’m not listing many, but they’re ones clients seem to enjoy the most.
Activity1. My most highly recommended icebreaker activity involves passing out blank slips of paper to each group member and instructing them to write a “fun fact” about themselves, something no one else in the group would know. I provide them with examples (i.e. “I once had a pet lamb named Bluebell” or “I won a hotdog eating contest when I was 11 and then threw up all over the judges’ shoes”). Depending on the crowd, you may want to tell clients not to write anything they wouldn’t want their peers to know. (I adopted this guideline after a client wrote about “sharting” himself.) Once everyone has written something, have them fold their papers and place in a container of some sort (a gift box, paper bag, plastic bowl, etc.) Group members take turns passing around the container (one-at-a-time) and picking a slip to read aloud. They must then guess who wrote it. (I give three guesses; after that, I turn it over to the group.)
Activity 2: A similar but more structured activity is to write out questions ahead of time and have clients take turns drawing and answering the questions. Questions can be silly, thought-provoking, or intending to illicit a strong emotional response (depending on the audience and goals for the group).
Activity 3: “People Search” involves a list of traits, feats, talents, or experiences. Each client receives the list and is given x amount of time to find someone in the group who is a match; that individual will then sign off. The first person to have their list completely signed sits down; they win. I typically let clients continue to collect signatures until two additional people sit down. (Prizes optional, but always appreciated.) During the debriefing, it’s fun to learn more (and thereby increase understanding and compassion).
Activity 4: “First Impressions” works best with group members who don’t know each other well. It’s important for group members to know each other’s names (or wear name tags). Each group member has a sheet of paper with various “impressions” (i.e. judgments/stereotypes). For example, items on the list might be “Looks like an addict” and “Looks intelligent.” Clients write other group members’ names for each impression. In addition to enhancing a sense of community, this activity provides an avenue for discussing harmful stereotypes and stigma.
Activity 5: Affirmations groups can be powerful, generating unity and kindness. The effect seems to be more pronounced in gender-specific groups. There are a variety of ways to facilitate an affirmations group, ranging from each person providing an affirmation to the client on their right to individuals sharing a self-affirmation with the group to creating a self-affirmation painting. Another idea is to give each client a sheet of paper. (Consider using quality, brightly-colored paper/posterboard and providing markers, gel pens, etc.) Clients write their name on it and then all the papers are passed around so each group member has the opportunity to write on everyone else’s sheet. Once their original paper is returned to them, they can read and share with the group. This can lead to a powerful discussion about image, reputation, feeling fake, etc. (Plus, clients get to keep the papers!)
Activity 6: “Most Likely to Relapse/Least Likely to Relapse” works best with a well-formed group and may require extra staff support. It’s good for larger groups and can be highly effective in a therapeutic community. Clients receive blank pieces of paper and are tasked to write the names of who they think is most likely and least likely to relapse. After writing their own name on the sheet, they turn it in to staff (effectively allowing staff to maintain a safe and productive environment). Staff then read each sheet aloud (without naming who wrote it). If they choose, clients can share what they wrote and provide additional feedback. (Most do.) Clients selected as “most likely” (in either category) have the opportunity to process with other group members and staff.
Access group therapy worksheets and handouts here.
In need of fresh material? It can be easy to fall into a rut, especially if you’re burnout or working with a particularly challenging group. The following three PDF downloads are lists of ideas for group topics. I also included two links to sites with helpful suggestions.
As a group facilitator, consider incorporating some sort of experiential activity, quiz, handout, game, etc. into every session. For example, start with a check-in, review a handout, facilitate a discussion, take a 5-minute bathroom break, facilitate a role-play, and then close the group by summarizing and providing clients with the opportunity to share what they learned. If that’s not feasible, provide coffee or snacks; sitting for 45 minutes is difficult for some, and 90 minutes can be unbearable.
Another idea is to have a “fun” or “free” group in the curriculum. Ideas include going bowling, having a potluck, Starbucks run, game group (i.e. Catchphrase, Pictionary, etc.), escape room, nature walk, etc.
Dealing With Challenges
Clients are not always willing therapy participants; some are court-ordered to attend or there to have privileges restored. Some attendees may be there “voluntarily,” but only to save their marriage or keep a job, not believing they need help. In residential treatment, clients attend mandatory groups as part of the daily schedule — participate or you’re out.
Even when attendance is truly voluntary, a group member may be in a bad space. Maybe they’re stressed about the rent or just got into a fight with their significant other. Or what if the AC is broken and the group room is 80 degrees? What if a client has unpleasant body odor or bad breath or an annoying cough?
Multiple factors combine and it’s suddenly a sh**show. (I’ll never forget the client who climbed onto a chair to “rally the troops” against my tyranny.) Anticipating challenges is the first step to effectively preventing and managing them.
Click here for an excellent article from Counseling Today that addresses the concept of client resistance.
Tips for dealing with challenges
If possible, co-facilitate. One clinician leads while the other observes. The observer remains attuned to the general “tone” of the group, i.e. facial expressions, body language, etc.
Review the expectations at the beginning of every group. Ask clients to share the guidelines with each other (instead of you telling them). This promotes a collaborative spirit.
After guidelines are reviewed, explain that while interrupting is discouraged, there may be times when you interject to maintain overall wellness and safety. (Knowing this, a client is less likely to get angry or feel disrespected when/if it happens.)
If you must interrupt, apologize, and explain the rationale.
Avoid power struggles at all costs, especially when a client challenges the benefits of treatment. (The unhealthier group members will quickly side with a challenger, leading to a complaint session.) Challenging the efficacy of treatment (or you as a clinician) is often a defense mechanism. Sometimes, the best response is simply “okay,” or none at all… and keep moving. You can also acknowledge the client’s perspective and ask to meet with them after group (and then get back on topic). If the group is relatively healthy, you may want to illicit feedback from other group members.
If a client becomes angry or tearful, give them time to vent for a moment or two (don’t “Band-Aid”); they may be able to self-regulate. (If they do self-regulate, share your observations and offer praise.)
If a client’s anger escalates to a disruptive level, ask them to take a break. At this point, their behavior is potentially triggering to other group members. Don’t raise your voice or ask them to calm down. Direct them step out and return when they’re ready. You may have to repeat yourself several times, but remain firm and calm, and they will eventually listen.
If a client is disrespectful (cursing at you or another client, name-calling, insulting, etc.) while escalated, let them know it’s not okay, but don’t attempt to provide feedback. (A simple, “Hey, that’s not okay,” will suffice.) Bring it up with the client later when they’re able to process.
Once the client who has been disrespectful leaves the room, acknowledge what happened and let the group know you will follow up with the client. If another client wants to talk about it, ask them to share only how it made them feel, but stress that it’s not okay to talk about an absent group member. (“How would you feel if we talked about you when you weren’t here?”) Strongly suggest that they wait until the person returns (and is open) to have a group discussion.
After a major blow-up (and once everyone is calm), it can be beneficial for the group to process it with the person who escalated. Group members can empathize/relate, share their observations and/or how it made them feel, and offer feedback.
If other disruptive behaviors occur in group (side conversations, snoring, etc.) address them in the moment (without shaming, of course). Point out the behavior and explain how it’s disruptive to the group. Refer back to the group guidelines. Ask group members to comment as well. If you let a behavior persist, hoping it will eventually stop, you’re sending the message that it’s okay, not only to the person who is disruptive, but to the entire group. This impacts the integrity of the group and opens things up for additional disruptive behaviors.
For clients who monopolize, who are constantly joking, or who attempt to intentionally distract by changing the topic, point out your observations and encourage group members to give feedback.
If, on the other hand, clients seem disengaged or unmotivated, seek out their feedback, privately or in the group, whichever is clinically appropriate.
If there’s a general level of disengagement, bring it up in the group. Remain objective and state your observations.
Anticipate that at times, people may not have much to say. (And while yes, there’s always something to talk about, that doesn’t mean someone is ready to or has the emotional energy to.) Maybe they’re distracted or tired or feeling “talked out.” It’s good to have backup plans: watch a psychoeducational film, take a walk in the park, listen to meditations or music, provide worksheets, education reading material, or coloring sheets.
Always keep in mind a client’s stage of change, their internal experiences (i.e. hearing voices, social anxiety, paranoia, physical pain, etc.), external circumstances (i.e. recent medication change, loss of housing, conflict with roommates, etc.), and history of trauma. What looks like resistance may be something else entirely.
Adverse Outcomes in Group Psychotherapy | Roback, H. B. (2000). Adverse outcomes in group psychotherapy: Risk factors, prevention, and research directions. The Journal of Psychotherapy Practice and Research, 9(3), 113–122.
Differences that Make a Difference | Change-Caffaro, S., & Caffaro, J. (2018). Differences that make a difference: Diversity and the process group leader. International Journal of Group Psychotherapy, 00: 1-15.
Group Interventions| Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. Indian Journal of Psychiatry, 60(Suppl 4), S514–S521.
Group Therapy for Substance Use Disorders | Wendt, D. C., & Gone, J. P. (2017). Group therapy for substance use disorders: A survey of clinician practices. Journal of Groups in Addiction & Recovery, 12(4), 243–259.
All About Group and Team Facilitation | (Source: The Free Management Library) This site provides free resources for managers, entrepreneurs, and leaders; much of the content on facilitation and teams is applicable to group facilitation
(Updated 5/20/20) A list of movies about mental health and substance abuse – includes PDF printable discussion questions
By Cassie Jewell, M.Ed., LPC, LSATP
Movies About Addiction & Mental Illness
The following is a list of films about substance use and mental disorders that are appropriate to show in treatment settings. This post includes movie summaries and downloadable PDF handouts with questions for discussion. Please note that some of the films on this list are graphic and may not be appropriate for children or adolescents.
(Disclaimer: This post contains affiliate links. As an Amazon Associate I earn from qualifying purchases.)
Hint: The handouts contain spoilers; do not provide until after the movie ends.
103 minutes (1 hour, 43 minutes), R-rating for language and drug use
Summary: Julia Roberts plays a mother, Holly, whose 19-year old son, Ben, surprises her by returning home for Christmas. Ben is newly in recovery; his addiction has placed a tremendous strain on the family in the past. Ben’s younger siblings are happy to see him, but Holly, fearing that he is not ready, is apprehensive. That evening, the family attends church. When they return, they find their home burglarized and the dog missing. Ben blames himself, believing someone from his past took the dog to get his attention; he leaves to look for the dog. Holly goes with him, but they’re later separated, and Holly attempts to track Ben. Eventually, she ends up at an abandoned barn where she finds her son on the floor, unresponsive. The movie ends with her administering Narcan to Ben.
127 minutes (2 hours, 7 minutes), R-rating for strong language and content relating to drugs, sexuality, and suicide
Summary: Winona Ryder plays Susanna, a young woman with borderline personality disorder, who is sent to a psychiatric hospital after a suicide attempt in the late 1960s. She befriends Lisa (Angelia Jolie), who carries a diagnosis of sociopathy (antisocial personality disorder). Initially, Susanna is in denial about her mental condition and is not open to treatment. However, she reaches a turning point after a tragedy.
123 minutes (2 hours, 3 minutes), PG-13 rating for mature thematic elements including substance abuse/recovery, some sexual situations, language, and brief violence
Summary: Trevor (Haley Joel Osment) starts a chain reaction of goodness for a social studies project with a plan to change the world for the better. In this film, Trevor is a high school student whose mother, Arlene (Helen Hunt), struggles with alcoholism and whose father is abusive. He rises above unfortunate circumstances with the kindhearted idea to do a good deed, but instead of requesting payback, asking the receiver to “pay it forward” to at least three people – and on and on. While the movie has a bittersweet end, the message is uplifting and powerful.
Summary: Charlie is an unpopular high school freshman, a “wallflower,” who is befriended by two seniors, Patrick and Sam (Emma Watson). The movie is about their friendship and Charlie’s personal struggles with the recent suicide of his friend and his own mental illness. Throughout the film, Charlie has flashbacks of his aunt, who died in a car accident when he was 7. It’s eventually revealed that Charlie’s aunt molested him; a sexual encounter with Sam triggers Charlie’s repressed memories. Charlie has a mental breakdown.
Other great resources for using clinical films as therapeutic interventions include the book Movies & Mental Illness: Using Films to Understand Psychopathy, 4th ed. (by Danny Wedding and Ryan M. Niemiec) and the site Teach With Movies.
(Updated 1/25/21) A list of sites with free printable resources for mental health clinicians and consumers
By Cassie Jewell, M.Ed., LPC, LSATP
Sites with Free Therapy Worksheets & Handouts
If you’re a counselor or therapist, you’re probably familiar with Therapist Aid, one of the most well-known sites providing free printable worksheets. PsychPoint and Get Self Help UK are also great resources for cost-free handouts, tools, etc. that can be used with clients or for self-help.
When I started blogging, I realized just how much the Internet has to offer when it comes to FREE! That being said, I’ve learned the term free is often misleading. There are gimmicky sites that require you to join an email list in order to receive a free e-book, PDF printables, etc.; I don’t consider that free since you’re making an exchange. I also dislike and generally avoid sites that bombard with ads. A third “free-resource” site that’s deceiving is the site with no gimmicks or ads, but turns out to be nothing more than a ploy to get you to buy something.
For this post, I avoided misleading sites and instead focused on government agencies, educational institutions, and nonprofits. I found some sites that offered a variety of broad-topic PDF resources and others that had fewer, but provided specialized tools. See below for links to over 50 sites with free therapy worksheets and handouts for both clinicians and consumers.
(Click here for free worksheets, handouts, and guides posted on this site.)
Attitudes and Behaviour | A 9-page PDF packet on criminal thinking (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Motivation To Change | A 16-page PDF packet on motivation to change criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Peers & Relationships | A 12-page PDF packet on how associates impact criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Danger Assessment Screening Tool | Clinicians can download a PDF version of this assessment, which helps predict the level of danger in an abusive relationship; this screening tool was developed to predict violence and homicide.
(Updated 1/25/21) A resource list for providers who work with youth and families, including free PDF manuals (for clinicians) and workbooks/toolkits/guides (for parents and families)
This is a list of free printable workbooks, manuals, toolkits, and self-help guides for children, adolescents, and families. This post is divided into two sections: resources for providers and resources for families.
Please repost this and/or share with anyone you think could benefit from these free resources!
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).
The Adolescent Coping with Stress Course: An Eight-Session Curriculum Developed for the Prevention of Unipolar Depression in Adolescents with an Increased Future Risk | Source: Kaiser Permanete for Health Research (Find more information here)
The Adolescent Coping with Stress Course: A Fifteen-Session Class Curriculum Developed for the Prevention of Unipolar Depression in Adolescents with an Increased Future Risk | Source: Kaiser Permanete for Health Research (Find more information here)
Growing Up Lesbian, Gay, Bisexual, or Transgender | Source: Department of Education and Skills and the Health Service Executive through the Social, Personal and Health Education Support Service in conjunction with GLEN (Gay and Lesbian Equality Network) and BeLonG To Youth Services & Professional Development Services for Teachers, 82 pages (Find more information here) 🏳️🌈
Anxiety Toolbox: Student Workbook | Source: Based on the Anxiety Toolbox curriculum at Counseling Services of California Polytechnic State University, San Luis Obispo, with modifications by the Broene Counseling Center of Calvin College, 42 pages (2017)
COPE | Source: West Carolina University Counseling and Psychological Services
A list of uncommon strategies for coping with stress, depression, and anxiety. Includes a free PDF version of the list to print and use as a handout.
By Cassie Jewell, M.Ed., LPC, LSATP
With Lauren Mills, MA, LPC-Intern (Contributor)
Effective coping skills make it possible to survive life’s stressors, obstacles, and hardships. Without coping strategies, life would be unmanageable. Dr. Constance Scharff described coping mechanisms as “skills we… have that allow us to make sense of our negative experiences and integrate them into a healthy, sustainable perspective of the world.” Healthy coping strategies promote resilience when experiencing minor stressors, such as getting a poor performance review at work, or major ones, such as the loss of a loved one.
Like any skill, coping is important to practice on a regular basis in order to be effective. Do this by maintaining daily self-care (at a minimum: adequate rest, healthy meals, exercise, staying hydrated, and avoiding drugs/alcohol.)
As an expert on you (and how you adapt to stressful situations), you may already know what helps the most when life seems out-of-control. (I like reading paranormal romance/fantasy-type books!) Maybe you meditate or run or rap along to loud rap music or have snuggle time with the cats or binge watch your favorite show on Netflix. Having insight into/awareness of your coping strategies primes you for unforeseeable tragedies in life.
“Life is not what it’s supposed to be. It’s what it is. The way you cope with it is what makes the difference.”
Virginia Satir, Therapist (June 26, 2019-September 10, 1988)
Healthy coping varies greatly from person to person; what matters is that your personal strategies work for you. For example, one person may find prayer helpful, but for someone who isn’t religious, prayer might be ineffective. Instead, they may swim laps at the gym when going through a difficult time. Another person may cope by crying and talking it out with a close friend.
Note: there are various mental health treatment approaches (i.e. DBT, trauma-focused CBT, etc.) that incorporate specialized, evidence-based coping techniques that are proven to work (by reducing symptoms and improving wellbeing) for certain disorders. The focus of this post is basic coping, not treatment interventions.
On the topic of coping skills, the research literature is vast (and beyond the scope of this post). While many factors influence coping (i.e. personality/temperament, stressors experienced, mental and physical health, etc.), evidence backs the following methods: problem-solving techniques, mindfulness/meditation, exercise, relaxation techniques, reframing, acceptance, humor, seeking support, and religion/spirituality. (Note that venting is not on the list!) Emotional intelligence may also play a role in the efficiency of coping skills.
A sport psychology study indicated that professional golfers who used positive self-talk, blocked negative thoughts, maintained focus, and remained in a relaxed state effectively coped with stress, keeping a positive mindset. Effective copers also sought advice as needed throughout the game. A 2015 study suggested that helping others, even strangers, helps mitigate the impact of stress.
Examples of coping skills include prayer, meditation, deep breathing, exercise, talking to a trusted person, journaling, cleaning, and creating art. However, the purpose of this post is to provide coping alternatives. Maybe meditation isn’t your thing or journaling leaves you feeling like crap. Coping is not one-size-fits-all. The best approach to coping is to find and try lots of different things!
The inspiration for this post came from Facebook. (Facebook is awesome for networking! I’m a member of several professional groups.) Lauren Mills sought ideas for unconventional strategies via Facebook… With permission, I’m sharing some of them here!
Unconventional Coping Strategies
Crack pistachio nuts
Fold warm towels
Smell your dog (Fun fact: dog paws smell like corn chips!) or watch them sleep
Peel dried glue off your hands
Break glass at the recycling center
Pop bubble wrap
Lie upside down
Watch slime or pimple popping videos on YouTube
Sort and build Lego’s
Write in cursive
Observe fish in an aquarium
Solve math problems (by hand)
Use a voice-changing app (Snapchat works too) to repeat back your worry/critical thoughts in the voice of a silly character OR sing your worries/thoughts aloud to the tune of “Happy Birthday”
Listen to the radio in foreign languages
Go for a joy ride (Windows down!)
Watch YouTube videos of cute animals and/or giggling babies
Walk barefoot outside
Draw/paint on your skin
Play with (dry) rice
Do (secret) “random acts of kindness”
Play with warm (not hot) candle wax
Watch AMSR videos on YouTube
Recite family recipes
Find the nicest smelling flowers at a grocery store
Use an app to try different hairstyles and/or makeup
People-watch with a good friend and make up stories about everyone you see (Take it to the next level with voiceovers!)
Wash your face mindfully
Buy a karaoke machine and sing your heart out when you’re home alone
On Instagram, watch videos of a hydraulic press smash things, cake decorating, pottery/ceramics throwing, hand lettering, and/or woodwork
Shine tarnished silver
Create a glitter jar and enjoy
Tend to plants
Color in a vulgar coloring book for adults
Download a PDF version (free) of “Unconventional Coping Strategies” below. This handout can be printed, copied, and shared without the author’s permission, providing it’s not used for monetary gain. Please modify as needed.
Regular self-evaluation is essential for mental health professionals. Use this daily assessment tool (downloadable PDF) to evaluate your ethical and self-care practices.
By Cassie Jewell, M.Ed., LPC, LSATP
The 10th Step of Alcoholics Anonymous (AA) suggests taking daily self-inventory: “A continuous look at our assets and liabilities, and a real desire to learn and grow.” The founders of AA recommended that a person in recovery both “spot check” throughout the day in addition to taking a full inventory every evening, preferably a written one.
An honest self-evaluation can assess for resentment, anger, fear, jealousy, etc. According to the principles of AA, self-inventory promotes self-restraint and a sense of justice; it allows one to carefully examine their motives. Furthermore, it allows one to recognize unhealthy or ineffective speech/actions in order to visualize how they could have done better.
Similarly, for best practice, self-evaluation is essential for anyone who works in the mental health (MH) field. It doesn’t have to take place daily, or even weekly, but it’s a necessary measure for any active MH worker. If we don’t regularly examine our motives, professional interactions, and level of burnout, we could potentially cause harm to those we serve.
“As important as it is to have a plan for doing work, it is perhaps more important to have a plan for rest, relaxation, self-care, and sleep.”
Autonomy (self-sufficiency), or fostering the right to control the direction of one’s life;
Nonmaleficence, or avoiding actions that cause harm;
Beneficence, or working for the good of the individual and society by promoting mental health and well-being;
Justice (remaining just and impartial), or treating individuals equitably and fostering fairness and equality;
Fidelity (integrity), or honoring commitments and keeping promises, including fulfilling one’s responsibilities of trust in professional relationships; and
Veracity (genuineness), or dealing truthfully with individuals with whom counselors come into professional contact
The following is a format for MH professionals to evaluate both ethical and self-care practices. It’s meant to be used as a daily assessment tool.
Daily Self-Inventory for Mental Health Professionals
1. Did I cause harm (physical or emotional) today, intentionally or unintentionally, to self or others?
❒ Yes ❒ No
2. If so, how, and what can I do to make amends and prevent reoccurrence?
3. Have I treated everyone I’ve come across with dignity and respect?
❒ Yes ❒ No
4. If no, how did I mistreat others? What were my underlying thoughts/feelings/beliefs? How can I act differently in the future?
5. Have I imposed my personal values on a client (or clients) today?
❒ Yes ❒ No
6. If so, which values, and what steps can I take to prevent this? (Note: professional counselors are to respect diversity and seek training when at risk of imposing personal values, especially when they’re inconsistent with the client’s goals.)
7. Currently, what are my personal biases and how can I overcome (or manage) them?
8. Have I done anything today that has not been in effort to foster client welfare (i.e. self-disclosure for self-fulfilling reasons)?
❒ Yes ❒ No
9. If so, what were my motives and how can I improve on this?
10. On a scale from 1-10 (1 being the least and 10 the greatest), how genuine have I been with both colleagues and clients?
11. On a scale from 1-10, how transparent have I been with both colleagues and clients?
12. What specific, evidence-based counseling skills, tools, and techniques did I use today? Am I certain there is empirical evidence to support my practice? (If no, how will I remedy this?)
13. Have I practiced outside the boundaries of my professional competence (based on education, training, supervision, and experience) today?
❒ Yes ❒ No
14. What have I done today to advance my knowledge of the counseling profession, including current issues, evidence-based practices, relevant research, etc.?
15. What have I done today to promote social justice?
16. Have I maintained professional boundaries with both colleagues and clients today?
❒ Yes ❒ No
17. Did I protect client confidentially to my best ability today?
❒ Yes ❒ No
18. To my best knowledge, am I adhering to my professional (and agency’s, if applicable) code of ethics?
❒ Yes ❒ No
19. On a scale from 1-10, what is my level of “burnout”?
20. What have I done for self-care today?
Self-Care Activities I’ve Engaged In:
❒ Adequate rest
❒ Adequate water intake
❒ Regular breaks throughout the workday
❒ Positive self-talk
Areas for Improvement:
Areas in Which I Excel:
Download a PDF version (free) of the self-evaluation below. This assessment can be printed, copied, and shared without the author’s permission, providing it’s not used for monetary gain. Please modify as needed.
Self-care is not a luxury; it’s necessary for survival when your loved one has a substance use disorder. By taking care of yourself, you gain the energy and patience to cope with your problems. Self-care promotes wellness and emotional intelligence; it puts you in a better space to interact with your loved one. Strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers.
By Cassie Jewell, M.Ed., LPC, LSATP
When your loved one has a substance use disorder (SUD), it can be overwhelming, distressing, and all-consuming. When we’re stressed, we forget to practice basic self-care, which in turn makes us even less equipped to cope with the emotional chaos addiction generates.
(Side note: I strongly recommend reading Beyond Addiction if your loved one has an SUD or if you work in the field. This book will increase your understanding of addiction and teach you how to cope with and positively impact your loved one’s SUD by using a motivational approach. This is one of the best resources I’ve come across, especially for family members/significant others.)
Based on the premise that your actions affect your loved one’s motivation, taking care of yourself is not only modeling healthy behaviors, it’s putting you in a better space to interact with your loved one. Chronic stress and worry make it difficult to practice self-care. Self-care may even seem selfish. However, by taking care of yourself and thus reducing suffering, you gain the energy and patience to cope with your problems (and feel better too). Furthermore, you reduce the level of pain and tension in your relationships with others, including your loved one with a SUD.
Self-care strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers. Therapy and/or support groups are additional options.
“An empty lantern provides no light. Self-care is the fuel that allows your light to shine brightly.”
Self-Care Strategies When Your Loved One Has an Addiction
The definition of resilience is “the capacity to recover quickly from difficulties” (Oxford Dictionary). Doctors Foote, Wilkens, and Kosanke wrote that having resilience is a way to “systematically reduce your vulnerability to bad moods, lost tempers, and meltdowns.” While you cannot “mood-proof” yourself entirely, resilience helps when facing life’s challenges, setbacks, and disappointments. To maintain resilience, one must practice at least the most basic self care practices, which are as follows:
Self-care is not something you can push in to the future. Don’t wait until you have more time or fewer obligations. Self-care is not a luxury; it’s a necessity. The authors of Beyond Addiction pointed out that self-care is something you have control over when other parts of your life are out of control. If you find it challenging to implement self-care practices, tap into your motivations, problem-solve, get support, and most of all, be patient and kind with yourself.
“Taking care of yourself is the most powerful way to begin to take care of others.”
On tolerance, Doctors Foote, Wilkens, and Kosanke suggested that it is “acceptance over time, and it is a cornerstone of self-care.” Tolerance is not an inherent characteristic; it is a skill. And like most skills, it requires practice. However, it’s wholly worth the effort as it reduces suffering. By not tolerating the things you cannot change (such as a loved one’s SUD), you’re fighting reality and adding to the anguish.
Techniques for distress tolerance include distracting yourself, relaxing, self-soothing, taking a break, and creating positive experiences. (The following skills are also taught in dialectical behavior therapy (DBT), an evidence-based practice that combines cognitive behavioral therapy techniques and mindfulness. For additional resources, visit The Linehan Institute or Behavioral Tech.)
Switch the focus of your thoughts. The possibilities are endless; for you, this could mean reading a magazine, calling a friend, walking the dog, etc. The authors of Beyond Addiction suggested making a list of ideas for changing your thoughts (and keeping it handy).
Switch the focus of your emotions. Steer your emotions in a happier direction by watching corgi puppies on YouTube, reading an inspirational poem, or viewing funny Facebook memes. The writers of Beyond Addiction suggested bookmarking sites in your Internet browser that you know will cheer you up.
Switch the focus of your senses. This could mean taking a hot shower, jumping into a cold pool, holding an ice cube in your hand, walking from a dark room to one that’s brightly lit, looking at bright colors, listening to loud rock music, etc. Also, simply walking away from a distressing situation may help.
Do something generous. Donate to your favorite charity, pass out sandwiches to the homeless, visit a nursing home and spend time with the residents, express genuine thanks to cashier or server, etc. By redirecting attention away from yourself (and directing energy toward positive goals), you’ll feel better. In Beyond Addiction, it’s noted that this skill is especially helpful for individuals who tend to ruminate. Also, it’s important to brainstorm activities that are accessible in the moment (i.e. texting a friend to let them know you’re thinking about them) that don’t take multiple steps (such as volunteering).
“Body tells mind tells body…” Relaxing your body helps to relax your mind. It also focuses your thoughts on relaxing (instead of your loved one’s addiction). What helps you to relax? Yoga? A hot bath? Mindful meditation? (I recommend doing a mindful body scan; it’s simple and effective, even for the tensest of the tense, i.e. me.)
In Beyond Addiction, self-soothing is described as “making a gentle, comforting appeal to any of your five senses.” A hot beverage. Nature sounds. A cozy blanket. A scenic painting. Essential oils. A cool breeze. A warm compress. A massage. Your favorite song. Find what works for you, make a list, and utilize as needed. Seemingly small techniques can make a big difference in your life by creating comfort and reducing out-of-control emotions.
Take A Break
“Taking a break” doesn’t mean giving up; it’s a timeout for when you’re emotionally exhausted. Learn to recognize when you need to step away from a situation or from your own thoughts. Find a way to shift your focus to something pleasant (i.e. a romantic movie, a nature walk, a day trip to the beach, playing golf for a few hours, traveling to a different country, etc.)
Create a Positive Experience
Doctors Foote, Wilkens, and Kosanke refer to this as “making it better,” not in the sense that you’re fixing the problem (or your loved one), but that you’re making the moment better by transforming a negative moment into a positive one. Suggested techniques include the following:
Half-smile. Another mind-body technique, half-smiling tricks your brain into feeling happier.
Meditate or pray. As explained in Beyond Addiction, “meditation or pray is another word for – and effective channel to – awareness and acceptance. Either one can open doors to different states of mind and act as an emotional or spiritual salve in trying moments.”
Move. By moving, you’re shifting your focus and releasing energy. Stretch, run, play volleyball, chop wood, move furniture, etc.
Find meaning. The authors of Beyond Addiction wrote, “Suffering can make people more compassionate toward others. Having lived through pain, sometimes people are better able to appreciate moments of peace and joy.” Suffering can also inspire meaningful action. What can you do to find meaning?
Borrow some perspective. How do your problems look from a different viewpoint? Ask a trusted friend. You may find that your perspective is causing more harm than good.
Perspective is “an understanding of a situation and your reactions to it that allows you to step back and keep your options open… [it’s] seeing patterns, options, and a path forward” (Beyond Addiction).
When Trish married Dave nearly 20 years ago, he rarely drank: maybe an occasional beer over the weekend or a glass of wine at dinner. After their fist daughter was born, his drinking increased to a few beers most nights. Dave said it helped him relax and manage the stress of being a new parent. By the time their second daughter was born several years later, his drinking had progressed to a six-pack of beer every evening (and more on weekends). Currently, Dave drinks at least a 12-pack of beer on weeknights; if it’s the weekend, his drinking starts Friday after work and doesn’t stop until late Sunday night.
Dave no longer helps Trish with household chores or yardwork as he did early in their marriage. He rarely dines with the family and won’t assist with the cooking/cleanup; he typically eats in front of the TV. Dave occasionally engages with his daughters, but Trish can’t recall the last time they went on a family outing, and it’s been years since they went on a date. Dave struggles to get out of bed in the mornings and is frequently late to work; Trish is worried he’ll get fired. They frequently argue about this. Dave is irritable much of the time, or angry. Most nights, he doesn’t move from his armchair (except to get another beer) until he passes out with the television blaring.
Trish is frustrated; she believes Dave is lazy and lacks self-control. When she nags about his drinking, he promises he’ll cut back, but never follows through. Trish thinks he’s not trying hard enough. She can’t understand why he’d choose booze over her and the kids; sometimes she wonders if it’s because she’s not good enough… maybe he would stop if she was thinner or funnier or more interesting? At times she feels helpless and hopeless and others, mad and resentful; she frequently yells at Dave. She wonders if things are ever going to change.
A different perspective would be to recognize that Dave has an alcohol use disorder. He feels ill most of the time, which affects his mood, energy level, and motivation. He wants to cut back, but fails when he tries, which leads to guilt and shame. To feel better, he drinks. It’s a self-destructive cycle. If Trish understood this, she could learn to not take his drinking personally or question herself. Her current reactions, nagging and yelling, only increase defensiveness and harm Dave’s sense of self-worth. Alternative options for Trish might include learning more about addiction and the reasons Dave drinks, bolstering his confidence, and/or creating a supportive and loving environment to enhance motivation.
In recovery language, a “trigger” is anything (person, place, or thing) that prompts a person with SUD to drink or use; it activates certain parts of the brain associated with use. For instance, seeing a commercial for beer could be triggering for a person with an alcohol use disorder.
You have triggers too. For example, if your loved one is in recovery for heroin, and you notice that a bottle of opioid painkillers is missing from the medicine cabinet, it could trigger a flood of emotions: fear, that your loved one relapsed; sadness, when you remember the agony addiction brings; hopelessness, that they’ll never recover. It’s crucial to recognize what triggers you and have a plan to cope when it happens.
Therapy and Support Groups
Lastly, therapy and/or support groups can be a valuable addition to your self-care regime. Seeing a therapist can strengthen your resilience and distress tolerance skills. Therapy may provide an additional avenue for perspective. (Side note: A good therapist is supportive and will provide you with tools for effective problem-solving and communication, coping with grief and loss, building self-esteem, making difficult choices, managing stress, overcoming obstacles, improving social skills/emotional intelligence, and better understanding yourself. A good therapist empowers you. A bad therapist, on the other hand, will offer advice and/or tell you what to do, disempowering you.)
Regarding support groups, there are many options for family members, friends, and significant others with a loved one who has a SUD, including Al-Anon, Nar-Anon, and Families Anonymous. Support groups provide the opportunity to share in a safe space and to receive feedback, suggestions, and/or encouragement from others who relate.
“I have come to believe that caring for myself is not self indulgent. Caring for myself is an act of survival.”
In sum, self-care is not optional; it’s essential for surviving the addiction of a loved one. Self-care enhances both overall wellness and your ability to help your loved one; in order words, take responsibility for your health and happiness by taking care of yourself.