Sites with Free Therapy Worksheets & Handouts

(Updated 5/4/20) A list of sites with free printable resources for mental health clinicians and consumers

By Cassie Jewell, M.Ed., LPC, LSATP

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.)

Please check back frequently; I update regularly.

Mental Health & Addiction (Sites with Worksheets/Handouts on a Variety of Topics)

91 Free Counseling Handouts | Handouts on self-esteem, emotions, recovery, stress, and more

A Change in Thinking: Self-Help Library | A large collection of worksheets and handouts on communication, relationships, depression, and more

A Good Way to Think: Resources | Worksheets and handouts on happiness, well-being, values, etc.

Articles by Dr. Paul David | Clinical handouts on depression, relationships, substance use disorders, family issues, etc.

ASI-MV Worksheets & Handouts | Addiction and recovery handouts

Belmont Wellness: Psychoeducational Handouts, Quizzes, and Group Activities | Printable handouts on assertiveness, emotional wellness, stress management, and more

Black Dog Institute: Clinical Resources | Download fact sheets, handouts, mood trackers, and more on a variety of mental health topics

Brene Brown: Downloads and Guides | Resources for work, parenting, the classroom, and daily life

Bryan Konik | Therapist & Social Worker: Free Therapy Worksheets | A collection of worksheets on stress management, anxiety, relationships, goal setting, and trauma

Cairn Center: Resources | A modest collection of printable assessments, handouts, and worksheets on DBT, anxiety, depression, etc.

Client Worksheets from Treatment for Stimulant Use Disorders (Treatment Improvement Protocols Services) | 44 client worksheets on addiction and recovery

Cornell Health: Fact Sheet Library | A variety of handouts and tracking sheet on various health topics; only a few relate to mental health and addiction

Daniel J. Fox, Ph.D.: Forms, Presentation Slides, and Worksheets | Topics include anger, emotions, borderline personality disorder, etc.

DOWNLOADS from Get Self Help | Free therapy worksheets and handouts on a variety of topics

Dr. Danny Gagnon, Ph.D., Montreal Psychologist: Self-Help Toolkits | Articles and handouts on worry, depression, assertiveness, etc.

EchoHawk Counseling: Materials and Resources | Articles, worksheets, and handouts on a variety of topics (boundaries, emotions, grief, stress, trauma, etc.)

Eddin’s Counseling Group: Worksheets | A short list of free worksheets and handouts

Faith Harper: Worksheets and Printables | A small collection of therapy worksheets and handouts, including a gratitude journal

Forward Ethos: Guide Sheets | Worksheets on mindfulness, anxiety, self-care, intimacy, relationships, and more

Free Stuff for Consumers and Professionals | A short list of downloads (Source: Jonathan S. Abramowitz, Ph.D.)

InFocus Resources | Family handouts on addiction

Lynn Martin | A short list of client handouts, including questionnaires

Mark R. Young, LMSW, LCSW (Resolving Concerns): Links & Forms | Links to factsheets, worksheets, assessments, etc.

Mental Health CE | Course content handouts on a variety of mental health topics

Motivational Interviewing Worksheets

My Group Guide: A Collection of Therapy Resources

Oxford Clinical Psychology: Forms and Worksheets | A large collection of therapy worksheets based on evidence-based practices

Peggy L. Ferguson, Ph.D.: Addiction Recovery Worksheets | A modest collection of handouts/worksheets for addiction and recovery

PsychPoint: Therapy Worksheets

Self-Help Exercises from Gambling Therapy

Self-Help Reading Materials | Links to handouts on self-help topics (Source: Truman State University)

Self-Help Tools from Mental Health America | Links to assessments, worksheets, handouts, and more

Sleep and Depression Laboratory: Resources | A small collection of worksheets related to sleep, worry, and depression

SMART Recovery Toolbox | Addiction and recovery resources

The Stages of Change | A 7-page PDF packet (Source: Virginia Tech Continuing and Professional Education)

Step Preparation Worksheets | (Source: treatmentguide4u.com)

Substance Abuse | A 13-page PDF packet

Taking The Escalator: Therapy Tools | Handouts on addiction and recovery

Therapist Aid | Free therapy worksheets

Therapy Worksheets | A therapy blog with links to free worksheets on various mental health topics

Tools for Coping Series | A large collection of handouts on coping skills

Worksheets from A Recovery Story (Blog) | A small collection of addiction and recovery worksheets

Depression, Stress, & Anxiety

Alphabet of Stress Management and Coping Skills | Coping skills for every letter of the alphabet

Anxiety 101 | An 11-page PDF packet (Source: Michigan Medicine | University of Michigan)

Anxiety Canada: Free Downloadable PDF Resources | Anxiety worksheets for parents and self-help

Behavioral Activation for Depression | A 35-page packet

Coping with Anxiety and Panic Attacks: Some Cognitive Behavioural Self-Help Strategies | A 10-page packet

Creating Your Personal Stress Management Plan | A 10-page packet

Dr. Chloe: Worksheets for Anxiety Management | A small collection of worksheets and handouts

Panic Attack Worksheets (Inner Health Studio) | A 9-page PDF packet

Relaxation | A 15-page packet on relaxation skills for anxiety

Stress Management (Inner Health Studio) | A 5-page packet on stress management

UMASS Medical School Department of Psychiatry: Stress Management – Patient Handouts | A collection of handouts on stress management. Some of the other sections, including “General Health and Wellness” and “Nutrition” have links to handouts as well

Trauma & Related Disorders

Center for Sexual Assault & Traumatic Stress: Therapist Resources | More than just worksheets: client handouts, assessments, info sheets, toolkits, training resources, links, etc.

Child and Family Studies: Sex in the Family | An 8-page packet on shame and guilt in relation to child sexual abuse

Common Reactions to Trauma | A 1-page PDF handout

Detaching From Emotional Pain (Grounding) | A 12-page PDF packet (Source: Sunspire Health)

Grounding Exercises | A 2-page PDF handout

Grounding Techniques | A 1-page PDF handout from JMU Counseling Center

Grounding Techniques | A 2-page PDF handout

Healing Private Wounds Booklets | Religious handouts on healing from sexual abuse

Seeking Safety Resources | Printable worksheets on PTSD, substance abuse, and healthy relationships

Selected Handouts and Worksheets from: Mueser, K. T., Rosenberg, S. D., & Rosenberg, H. J. (2009). Treatment of Postraumatic Stress Disorder in Special Populations: A Cognitive Restructuring Program | A 13-page PDF packet

Trauma Research and Treatment: Trauma Toolkit A small collection of trauma handouts

Traumatic Stress: The Effects of Overwhelming Experience on the Mind and Body | A 12-page PDF packet (Source: Dan Metevier, Psy.D., Clinical Psychologist)

Wisconsin Hawthorn Project: Handouts & Worksheets | Handouts in English and Spanish

Psychosis

CBT for Psychosis & Trauma Handouts

Early Psychosis Intervention: Client Worksheets | Scroll down to the “Client Worksheets” section for links. Use with clients who are experiencing psychosis

Goal-Setting Worksheet for Patients with Schizophrenia | A 3-page PDF

List of 60 Coping Strategies for Hallucinations | A 2-page PDF

Treatment for Schizophrenia Worksheet Pack | A 6-page PDF packet

ACT, CBT, & DBT

ACT Mindfully: Worksheets, Book Chapters & ACT Made Simple | ACT worksheets and other free resources

Cognitive Therapy Skills | A 33-page packet

Carolina Integrative Psychotherapy | A small collection of DBT worksheets and handouts

Clinician Worksheets and Handouts: Clinician Treatment Tools | A variety of CBT, DBT, etc. therapy worksheets

CPT Web Resources | A short list of worksheets and handouts

DBT Peer Connections: DBT Handouts and Worksheets | DBT resources

DBT Self-Help | Printable lessons and diary cards

Dr. John Forsyth: Free Resources | Download two free packets of worksheets (ACT and mindfulness)

Living CBT: Free Self-Help | 20+ CBT worksheets

Lozier & Associates: Dialectical Behavior Therapy Printables – DBT Worksheets and DBT Handouts | A small collection of DBT handouts and worksheets

Printable Versions of CPT/CBT Worksheets | English and Spanish worksheets (Source: The F.A.S.T. Lab at Stanford Medicine)

Veronica Walsh’s CBT Blog: Free Downloadable Cognitive Behavioural Therapy Worksheets/Handouts | Print/use these worksheets only with blog author’s permission

Grief & Loss

Activities for Grieving Children | A 7-page PDF

Bereavement Handouts (Hospice & Palliative Care) | A small collection of handouts

The Center for Complicated Grief: Handouts | Assessments, handouts, and guides

A Child’s Understanding of Death | An 11-page packet

Handouts to Download and Print: One Legacy | Handouts on grief and loss

Loss and Grief Handouts

Loss, Grief, and Bereavement | A 35-page PDF packet

Grief Factsheets: My Grief Assist

Printable Grief and Loss Resources | A fairly extensive collection of printable handouts on grief and loss

Anger

Anger Inventory | A 7-page PDF packet

Anger Management | A 13-page PDF packet

Anger Management Techniques | A 4-page PDF

Dealing with Anger (Inner Health Studio) | A 7-page PDF packet

Free Anger Management Worksheets: Letting Go of Anger | A small collection of worksheets for anger management

Getting to Know Your Anger | A 42-page PDF packet

Love To Know: Free Anger Worksheets | 7 downloadable anger management worksheets

Steps for Change: Anger Management Worksheets

Self-Esteem

Confidence Activities | A 25-page PDF packet

Free Self-Esteem Worksheets

Growing Self-Esteem: Self-Esteem Worksheets

Improving Self-Esteem: Healthy Self-Esteem | A 10-page PDF packet

Self-Esteem Activities | A modest collection of handouts/activities for self-esteem

Self-Esteem Experts: Self-Esteem Activities | Printable handouts on self-esteem

Self-Esteem Printable Worksheets

Spiritual Self-Schema Development Worksheets: Yale School of Medicine

Values & Goal-Setting

10 Free Printable Goal-Setting Worksheets (from Parade)

Core Values and Essential Intentions Worksheet | A 2-page PDF worksheet

Core Values Clarification Exercise | A 4-page PDF worksheet

Core Values Worksheet | A 4-page PDF worksheet

Life Values Inventory | A 5-page printable PDF (Source: Brown, Duane and R. Kelly Crace, (1996). Publisher: Life Values Resources, pinnowedna@charter.net)

Personal Values Card Sort | A 9-page printable PDF (Source: W.R. Miller, J. C’de Baca, and D.B.Matthews, P.L., Wilbourne, University of New Mexico, 2001)

Values | A 2-page PDF worksheet

Values and Goals Worksheet | A 1-page PDF worksheet

Values Assessment Worksheet | A 2-page PDF worksheet

Values Exercise | A 2-page PDF worksheet

Values Identification Worksheet | A 6-page PDF worksheet (Source: Synergy Institute Online)

Values Inventory Worksheet | A 2-page PDF worksheet

What Are My Values? | A 4-page PDF worksheet from stephaniefrank.com

Children & Youth

A Child’s Understanding of Death | An 11-page packet

A Collection of Anger Management/Impulse Control Activities & Lesson Plans (PreK-3rd Grade) | A 64-page PDF packet

Activities for Grieving Children | A 7-page PDF

Cope-Cake: Coping Skills Worksheets and Game | A 30-page packet for young children/students

Crossroads Counseling Center: Resources | Handouts on depression, anxiety, ADHD, etc. in children

Curriculum Materials from Pennsylvania Child Welfare Resource Center | Links to handouts

The Helpful Counselor: 10 Awesome Behavior Management Resources | Worksheets to use with children

Myle Marks: Free Downloads | Worksheets for children

Prevention Dimensions: Lesson Plans | Downloadable PDF handouts for children from kindergarten to sixth grade (Source: Utah Education Network)

Printable Worksheets | Worksheets for children on physical activity, substance abuse, nutrition, and more (Source: BJC School Outreach and Youth Development)

Social Emotional Activities Workbook | A 74-page PDF packet

Social Skills Worksheets | A packet of worksheets to use with children/youth

Stress Reduction Activities for Students | Link to a 20-page packet (PDF)

Adolescents & Young Adults

Change To Chill | Worksheets and handouts for reducing stress in teens and young adults

Emotional Intelligence Activities for Teens Ages 13-18 | A 34-page PDF packet

Handouts: Eppler-Wolff Counseling Center (Union College) | Handouts for college students

Healthy Living (Concordia University) | Handouts and articles for college students

Just for Teens: A Personal Plan for Managing Stress | A 7-page PDF handout

Oregon State University: Learning Corner | Student worksheets on time management, wellness, organization skills, etc.

The Relaxation Room (Andrews University) | Self-care and stress management handouts for college students

Resilience Toolkit from Winona State University | PDF handouts for college students on resiliency

Self-Help Resources from Metropolitan Community College Counseling Services | Links to articles for college students on a variety of topics (not in PDF form)

Self-Help (Western Carolina University) | Handouts for college students

Step UP! Program Worksheets and Handouts | Worksheets/handouts for students on prosocial behavior and bystander intervention

Teens Finding Hope: Worksheets and Information to Download | Spanish and English PDFs available

Tip Sheets from Meredith College Counseling Center | Student tip sheets on anger, body image, relationships, and other topics

Tools & Checklists from Campus Mind Works | Handouts and worksheets for students

UC Berkeley University Health Services Resources | Links to handouts, articles, and self-help tools for students

UMatter | Tools for college students on wellness, communication, healthy relationships, and more (Source: Princeton University)

Western Carolina University Counseling and Psychological Services: Self-Help | A modest collection of student wellness handouts along with a printable self-help workbook

Your Life Your Voice (from Boys Town): Tips and Tools | Links to articles and PDF printables on a variety of topics for teens and young adults

Marriage/Relationships & Family

21 Couples Therapy Worksheets, Techniques, & Activities | From Positive Psychology

Articles for Parenting from MomMD | Links to various articles/handouts (not in PDF form)

Drawing Effective Personal Boundaries | A 2-page PDF handout (Source: liveandworkonpurpose.com)

Emotionally Focused Therapy: Forms for Couples | A list of forms to use in EFT couples counseling

Exercises for Forgiveness | A 7-page PDF for recovering from an emotional affair

Healthy Boundaries by Larry L. Winckles | A 3-page PDF handout

Healthy Boundaries Program | A 15-page PDF packet (Source: The University of Toledo Police Department)

Healthy Boundaries vs. Unhealthy Boundaries | A 6-page PDF handout (Source: kimsaeed.com)

Hope Couple: Counseling Resources | Assessments and worksheets from a Christian counseling site

Joy2MeU | A collection of articles by Robert Burney on relationships, codependency, and related topics (not in PDF form)

New Beginnings Family Counseling: Handouts | Click on “Resources” to view and download handouts on relationships, anxiety, and depression. You can also download relationship assessment tools

Pasadena Marriage Counseling: Free Marriage Counseling Resources | A small collection of worksheets for couples therapy

Relationship Counseling Forms | PDF forms for couples therapy (Source: Dan Metevier, Psy.D., Clinical Psychologist)

Signs of Unhealthy Boundaries | A 6-page PDF handout (Source: Healing Private Wounds)

Additional Worksheets & Handouts

8 Helpful “Letting Go of Resentment” Worksheets | Links to PDF worksheets

90-Day Health Challenge | Several health worksheets for download (Source: HealthyCampbell)

Acorns to Oaktrees: Eating Disorder Worksheets/Eating Disorder Forms | A small collection of handouts for eating disorders

Activity eBooks from Rec Therapy Today | A collection of downloadable workbooks on self-esteem, social skills, emotions, etc.

Alzheimer’s Association: Downloadable Resources | Handouts on Alzheimer’s

Attitudes and Behaviour | A 9-page PDF packet on criminal thinking

Commonly Prescribed Psychotropic Medications | A-page PDF (Source: NAMI Minnesota)

Conflict Resolution Skills | A 6-page PDF packet

Coping Skills | A 2-page PDF worksheet (Source: Temple University)

EDA Step Worksheets | From Eating Disorders Anonymous

Experiential Group Exercises for Shame-Resilience | A 4-page PDF packet with questions for discussion and group activities

Free Mindfulness Worksheets (Mindfulness Exercises) | A large collection of mindfulness handouts

Go Your Own Way | Downloads for veterans on various topics

Guilt vs. Shame Infographic: National Institute for the Clinical Application of Behavioral Medicine | Printable infographic to illustrate the differences

Handouts and Worksheets | A 21-page PDF packet with handouts and worksheets on selfe-care topics

Homework and Handouts for Clients: ACT With Compassion | Handouts and worksheets related to self-compassion

Integrated Health and Mental Health Care Tools | Downloadable resources from UIC Center

International OCD Foundation: Assessments & Worksheets | Handouts for use with individuals with OCD

Learning to Forgive: The 5 Steps to Forgiveness | A 6-page PDF handout from Thriveworks

Managing Emotional Intelligence | A 7-page PDF packet (Source: inclusiv.org)

Motivation To Change | A 16-page PDF packet on motivation to change criminal behavior

Peers & Relationships | A 12-page PDF packet on how associates impact criminal behavior

Personal Development: Workplace Strategies for Mental Health | Handouts on resilience, communication, etc.

Prochaska and DiClemente’s Stages of Change Model | A 4-page PDF handout

Quick Reference to Psychotropic Medication | Downloadable PDF chart from John Preston, Psy.D.

Radical Forgiveness: Free Tools | A small collection of worksheets on forgiveness

Reducing Self-Harm | A 5-page PDF

Self-Care and Wellness Resources | Printable handouts and tools (Source: irenegreene.com)

Self-Care Starter Kit from University at Buffalo School of Social Work | Handouts on self-care topics

Self-Directed Recovery | Downloadable resources from UIC Center

Shame Psychoeducation Handout | A 5-page PDF handout

Stages of Change: Primary Tasks | A 2-page PDF handout

Therapy Worksheets: ADHD ReWired | Thought records, behavior charts, and other tools

Understanding and Coping with Guilt and Shame | A 4-page PDF handout

Wellness Toolkits | Printable toolkits from NIH


Please contact me if a link is no longer valid or if you’d like to recommend a site!

Unconventional Coping Strategies

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.

Current research

In 2011, researchers found that positive reframes, acceptance, and humor were the most effective copings skills for students dealing with small setbacks. The effect of humor as a positive coping skill has been found in prior studies, several of which focused on coping skills in the workplace.

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

1) Crack pistachio nuts

2) Fold warm towels

3) Smell your dog (Fun fact: dog paws smell like corn chips!) or watch them sleep

4) Peel dried glue off your hands

5) Break glass at the recycling center

6) Pop bubble wrap

7) Lie upside down

8) Watch slime or pimple popping videos on YouTube

9) Sort and build Lego’s

10) Write in cursive

11) Observe fish in an aquarium

12) Twirl/spin around

13) Solve math problems (by hand)

14) 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”

15) Listen to the radio in foreign languages

16) Chop vegetables

17) Go for a joy ride (Windows down!)

18) Watch YouTube videos of cute animals and/or giggling babies

19) Blow bubbles

20) Walk barefoot outside

21) Draw/paint on your skin

22) Play with (dry) rice

23) Do (secret) “random acts of kindness”

24) Play with warm (not hot) candle wax

25) Watch AMSR videos on YouTube

26) Shuffle cards

27) Recite family recipes

28) Find the nicest smelling flowers at a grocery store

29) Count things

30) Use an app to try different hairstyles and/or makeup

31) People-watch with a good friend and make up stories about everyone you see (Take it to the next level with voiceovers!)

32) Wash your face mindfully

33) Buy a karaoke machine and sing your heart out when you’re home alone

34) On Instagram, watch videos of a hydraulic press smash things, cake decorating, pottery/ceramics throwing, hand lettering, and/or woodwork

35) Shine tarnished silver

36) Create a glitter jar and enjoy

37) Tend to plants

38) 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.


Lauren Mills, MA, LPC-Intern (Supervised by Mary Ann Satori, LPC-S) is a therapist in Texas and a current resident in counseling.     

I’d like to acknowledge all members of Therapist Toolbox – Resources & Support for Therapists who submitted ideas!

If you have an uncommon coping skill, post in a comment!


References

Association for Psychological Science. (2015, December 14). Helping others dampens effects of everyday stress. ScienceDaily. Retrieved January 13, 2020 from http://www.sciencedaily.com/releases/2015/12/151214084744.htm

Canisius College. (2008, January 26). Laughter is the best medicine. ScienceDaily. Retrieved January 13, 2020 from http://www.sciencedaily.com/releases/2008/01/080124200913.htm

Loyola University Health System. (2018, September 21). Boosting emotional intelligence in physicians can protect against burnout. ScienceDaily. Retrieved January 12, 2020 from http://www.sciencedaily.com/releases/2018/09/180921140200.htm

Scharff, C. (2016). Understanding and choosing better coping skills: You can change your mood without drugs. Psychology today. Retrived from https://www.psychologytoday.com/us/blog/ending-addiction-good/201609/understanding-and-choosing-better-coping-skills

University of Alberta. (2005, June 18). A good game of golf: Mind over matter. ScienceDaily. Retrieved January 13, 2020 from http://www.sciencedaily.com/releases/2005/06/050617235448.htm

University of Kent. (2011, July 14). Positive reframing, acceptance and humor are the most effective coping strategies. ScienceDaily. Retrieved January 12, 2020 from http://www.sciencedaily.com/releases/2011/07/110704082700.htm

Wiley-Blackwell. (2008, April 9). Humor plays an important role in healthcare even when patients are terminally ill. ScienceDaily. Retrieved January 13, 2020 from http://www.sciencedaily.com/releases/2008/04/080408112104.htm

5 Instant Mood Boosters

Discover five ways to instantly boost your mood and uplift your spirits.

By Cassie Jewell, M.Ed., LPC, LSATP

Need a boost? Here are five quick (evidence-based) fixes for when you’re feeling down.


Listen to music

Turn on the radio or search for your favorite song on YouTube. Music can evoke a powerful emotional response. Listen to something upbeat with a positive message. Music activates areas in the brain that are responsible for processing emotions.

“Music produces a kind of pleasure which human nature cannot do without.” 

Confucius

Be mindful while listening to a happy tune; pay attention to your emotions and challenge yourself to feel happier. In one study, participants who listened to upbeat music experienced improved mood as well as increased happiness over the next two weeks. A 2017 study indicated that listening to your favorite songs impacts the brain circuit involved in internally focused thought, empathy, and self-awareness. Interestingly, it doesn’t matter what type of music you choose; the effect is consistent across genres. Music may play a role in restoring neuroplasticity or as a therapeutic intervention. In 2013, researchers found that listening to uplifting concertos from Vivaldi’s Four Seasons was linked to enhanced cognitive functioning. An additional benefit to listening to music is improved mental alertness; memory and attention in particular may be enhanced.

Find a green space

Go hiking, find a sunny spot to sit outside, or simply open the window and listen to the sound of the rain falling. According the U.S. Forest Service, spending time in nature can reduce stress, improve mood, reduce anger/aggressiveness, and increase overall happiness. If you’re upset or frustrated, you’ll recover more quickly in a natural setting, such as a forest. Alternatively, consider a stroll in the park for a boost. Researchers found that individuals with depression who took an hour-long nature walk experienced significant increases in attention and working memory when compared to individuals who walked in urban areas. Interestingly, both groups of participants experienced similar boosts in mood; walking in an urban area can be just as effective!

More recently, researchers found that people who regularly commute through natural environments (i.e. passing by trees, bodies of water, parks, etc.) reported better mental health compared to those who don’t. This association was even stronger among active commuters (walking or biking to work). If you commute through congested or urban areas, consider an alternate route, especially when you’re feeling down.

Spending time outside does more than just improve your mood. A 2018 report established a link between nature and overall wellness. Living close to nature and spending time outside reduces the risk of type II diabetes, cardiovascular disease, premature death, preterm birth, stress, and high blood pressure. Exposure to green space may also benefit the immune system, reduce inflammation, and increase sleep duration.

Read/view something inspiring or humorous

Do you have a favorite inspirational book or collection of poems? Do you like viewing motivational TED Talks? Do you enjoy comedy shows? Maybe you like watching videos of baby goats or flash mobs on Facebook. (I do!) One study found that viewing cat videos boosted energy and positive emotions while decreasing negative feelings (such as anxiety, annoyance, and sadness). Internet cats = Instant mood boost. However, if Internet cats are not your thing, search around to find something enjoyable to read or watch for your happiness quick-fix.

Plan your next adventure

I’m happiest when I’m traveling the world. Unfortunately, I have limited vacation days (as well as limited funds), which means I don’t get to travel as often as I’d like. Happily, planning a trip may produce the same mood-boosting effects as going on a trip. In 2010, researchers found that before taking a trip, vacationers were happier compared to those not planning a trip. A 2002 study indicated that people anticipating a vacation were happier with life in general and experienced more positive/pleasant feelings compared to people who weren’t. In both studies, researchers attributed happiness levels to anticipation. (The brain releases dopamine during certain activities, causing us to feel pleasure. Dopamine is also released in anticipation of a pleasurable activity.) To increase happiness, start planning!

Cuddle a pet

Spending time with your fur baby will instantly boost your mood. According to research, pets are good for your mental health. Teens undergoing treatment for drug and alcohol abuse experienced improved mood, positive affect, attentiveness, and serenity after brushing, feeding, and playing with dogs. A 2018 study indicated that dog therapy sessions reduced stress and increased happiness and energy in college students. Earlier this year, researchers found that just 10 minutes of interaction with a pet reduced stress by significantly decreasing cortisol (a stress hormone) levels. Other studies suggest that animal-assisted therapy reduces anxiety and loneliness and combats homesickness.

Research indicates that pets help seniors and older adults cope with physical and mental health concerns. Dog ownership is also linked to better cardiovascular health and a longer life.

“Happiness is a warm puppy.”

Charles M. Shultz

The next time you’re having a bad day, listen to your favorite song, go hiking in the woods, watch a TED Talks, start planning your next vacation, or spend some quality time with a furry friend… you’ll feel better!

Self-Care Strategies When Your Loved One Has an Addiction

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.  

In the book Beyond Addiction: A Guide for Families, the authors discuss the importance of self-care. This post reviews suggested strategies. (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.)

Image by Pexels from Pixabay

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.”

Unknown

Resilience

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:

  1. Eat well
  2. Sleep well
  3. Exercise enough
  4. Avoid mood-altering drugs (including alcohol)
  5. Treat illness (with prescribed medications, adequate rest, etc.)
Image by Irina L from Pixabay

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.”

Bryant McGill

Distress Tolerance

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.)    

Distract Yourself

  1. 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).
  2. 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.
  3. 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.
  4. 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).
Image by congerdesign from Pixabay

Relax

“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.)

Soothe Yourself

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.)

Image by Free-Photos from Pixabay

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:

  1. Half-smile. Another mind-body technique, half-smiling tricks your brain into feeling happier.
  2. 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.”
  3. Move. By moving, you’re shifting your focus and releasing energy. Stretch, run, play volleyball, chop wood, move furniture, etc.
  4. 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?
  5. 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

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.  

Image by Luis Wilker Perelo WilkerNet from Pixabay

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.

Triggers

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.)

Image by HannahJoe7 from Pixabay

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.”

Audre Lorde

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.

For more information on how you can help your loved one, visit The Center for Motivation and Change.

Books & Resources for Therapists

(Updated 5/5/20) A resource list for therapists and other mental health professionals, including book recommendations and sites that link to (free!) printable worksheets, handouts, and more.

By Cassie Jewell, M.Ed., LPC, LSATP

This is a list of resources for mental health professionals. Please check back as I update regularly. If you have a suggestion, use the contact form on this site.


Books

Armstrong, C. (2015). The Therapeutic “Aha!” Strategies for Getting Your Clients Unstuck.

Belmont, J. (2015). The Therapist’s Ultimate Solution Book.

Buchalter, S. I. (2017). 250 Brief, Creative & Practical Art Therapy Techniques: A Guide for Clinicians and Clients

Rosenglen, D. B. (2018). Building Motivational Interviewing Skills: A Practitioner Workbook, 2nd ed.

The PracticePlanners Series


Websites & Blogs

ACEs Connection | An ACEs community for connecting with others who practice trauma-informed care. You can also access the latest news and research related to ACEs; this site also has a huge resource section with guides, surveys, webinars, and more.

ACT Mindfully | A variety of free worksheets, handouts, book chapters, articles, and more. Acceptance and Commitment Therapy (ACT) is a unique and creative model for both therapy and coaching; a type of cognitive behavioural therapy based on the innovative use of mindfulness and values.

Association for Behavioral and Cognitive Therapies | Info and clinical resources, including archived Webinars and podcasts

The Centre for Applied Research in Mental Health and Addiction – Tools and Resources | The Centre for Applied Research in Mental Health and Addiction (CARMHA) is an internationally recognized research centre based at the Faculty of Health Sciences, Simon Fraser University, Vancouver. CARMHA conducts innovative and interdisciplinary scientific research related to mental health and substance use, primarily in the areas of clinical or other intervention practice, health systems and population health and epidemiology. Access free downloadable workbooks for stress in the workplace, depression, coping with chronic pain, and other topics.

Character Lab | A collection of “playbooks” for character-building in children

Collaborative Mental Health Care: Child & Youth Mental Health Toolkits | Assessments, handouts, resources guides, links to relevant sites, and more

Compassion Fatigue & Healthcare Professionals: An Online Guide | Resources for coping with compassion fatigue

Confident Counselors | A collaborative blog written by school counselors, school psychologists, and school social workers

Counselling Resource | A resource site for mental health professionals and consumers. Includes interactive assessments, free PDF printables, and information related to online practice and clinical supervision.

Counselor: The Magazine for Addiction & Behavioral Health Professionals | Blog posts written by substance use and mental health providers

Education4Health | The resource section includes a variety of PDF booklets, guides, and workbooks

Evidence-Based Behavioral Practice | Information on evidence-based behavioral practices: includes tools, assessments, videos, and free online training modules

Expressive Art Inspirations: Free Expressive Arts Learning Library | A collection of creative art techniques

Expressive Therapist: Group Activities | A list of ideas for groups of children, teens, and adults

Guided Self-Change | A great resource for SUD assessments, group materials, and handouts

Get Self-Help – Free Resources | This website provides CBT self-help and therapy resources, including a large collection of worksheets and information sheets and self-help mp3s; a useful tools for therapists or individuals seeking to manage a mental health condition.

The Helpful Counselor | Resources for school counselors

National Center for PTSD for Professionals | Free handouts, toolkits, online trainings, and more

Personality Lab | Articles, assessments, dissertations, etc. on personality intelligence

Positive Psychology Program | This site contains a wealth of free assessments, PDF printables, activities, handouts, worksheets, and more. Search by category or browse blog posts.

PsyberGuide | A nonprofit organization that discovers and reviews mental health apps, which are rated as unacceptable, questionable, or acceptable. You can also search target conditions and treatments. Use this site to make recommendations to your clients.

PsychCentral | Articles, news, blogs, forums, interactive quizzes, and more

Self-Care Starter Kit from University at Buffalo School of Social Work | Designed to prevent/treat burnout, this kit includes info on vicarious trauma, assessments, meditations, and helpful links to additional self-care resources

SMI Adviser | Search topics and find resources for SMI. You can also access a variety of free online courses to earn CE credits.

Social Work Helper | Mental health articles and resources

Society for Adolescent Health: Mental Health (ADOLESCENT AND YOUNG ADULT CLINICAL CARE RESOURCES) | Toolkits, apps, guides, manuals, videos, reports, and more

Society for the Advancement of Psychotherapy | Articles, book reviews, and more on relevant topics

Society of Clinical Psychology (Division 12) | A division of the American Psychological Association, this site provides an up-to-date list of evidence-based treatments, and includes links to free assessments, manuals, handouts, etc. for many of the treatments

TherapyAdvisor.org | A searchable database of empirically supported treatments for SUD and MH

Therapy Worksheets | A blog by Will Baum, LCSW, with links to free therapy worksheets

Handouts & Worksheets

CBT for Psychosis & Trauma & Psychosis Handouts | A short list of helpful handouts; this site is also a source for blog posts on psychosis and trauma (by Ron Unger, LCSW)

Centre for Clinical Interventions | Free downloadable workbooks on anxiety, self-esteem, eating disorders, panic, perfectionism, and more

Kim’s Counseling Corner – Therapy and Self-Help Worksheets | Kim Peterson, LPC-S, specializes in child and teen issues, parenthood, play therapy and relationships. She provides links to online worksheets or PDF versions that she has collected over time as a therapist. Topics include abuse, depression, anxiety, self-harm, and more.

Marriage Intelligence: “Love Tools” | Free downloadable worksheets for surviving infidelity, forgiveness, communication, etc.

Mind Tools | Free management, leadership, and personal effectiveness worksheets and tools. (Join the Mind Tools Club for a fee to access additional tools and online courses.)

Oxford Clinical Psychology: Forms and Worksheets | A vast collection of forms, handouts, and assessments on anxiety, OCD, depression, parenting, substance use, and more

Psychology Tools | Psychology Tools is a leading online resource for therapists. Download free worksheets, assessments, and guides.

PsychPoint | Articles and worksheets

Therapist Aid | An extensive collection of free evidence-based education and therapy tools. Download customizable worksheets or access articles and treatment guides. An invaluable resource for therapists.

Ultimate Solution Handouts | Free printable handouts for therapists (from Judith Belmont)

UW Medicine: Harborview Medical Center (Center for Sexual Assault and Traumatic Stress) | Handouts/worksheets for clients on coping with challenging thoughts, anxiety, anger, etc. The site also includes a list of assessments.


For additional sites, see Sites with Free Worksheets & Handouts.

For free resources posted on this site, click here.

social media Groups & Forums

Continuing Ed Collective (Facebook)

Counseling Psychology (Reddit)

Marriage & Family Therapists (Facebook)

Professional Mental Health Counselors, Social Workers, & Psychologists (Facebook)

Psychology (Reddit)

Psychotherapy: A Place for Therapists (Reddit)

A Spot for Social Workers… (Reddit)

Therapist Toolbox (Facebook)

Training Resource Group for Mental Health Professionals (Facebook)

12-Step Recovery Groups

(Updated 5/21/20) An extensive list of support groups for recovery

Compiled by Cassie Jewell, M.Ed., LPC, LSATP

There are a variety of 12-step support groups for recovery. 12-step meetings are not facilitated by a therapist; they’re self-run. Support groups are not a substitute for treatment, but can play a crucial role in recovery.

The following list, while not comprehensive, will link you to both well-known and less-familiar 12-step (and similar) organizations and support groups for recovery.

Click below for a downloadable PDF version of this post.

Support Groups for Addiction

Alcoholics Anonymous (AA)

Narcotics Anonymous (NA)

heroin anonymous (HA)

pills anonymous (PA)

Cocaine Anonymous (CA)

Crystal Meth Anonymous (CMA)

Marijuana Anonymous (MA)

Nicotine Anonymous (NicA)

caffeine addicts anonymous (cafaa)

chemically dependent anonymous (CDA)

all addicts anonymous (AAA)

recoveries anonymous (R.a.)

pharmacists recovery network

international doctors in alcoholics anonymous (IDAA)

international lawyers in alcoholics anonymous (ILAA)

association of recovering motorcyclists (A.R.M.)

For Families and Others Affected by Addiction and Mental Illness

Al-Anon/Alateen (For Family and Friends of Alcoholics)

Nar-Anon (For Family and Friends of Addicts)

Adult Children of Alcoholics (ACA)/Dysfunctional Families

Families Anonymous (FA)

parents anonymous

NAMI Family Support Group (For Adults with Loved Ones Who Have Experienced Mental Health Symptoms)

S-Anon/S-Ateen (For Family and Friends of Sexaholics)

codependents of sexual addiction – COSA (for those whose lives have been affected by another’s compulsive sexual behavior)

gam-anon (for families and friends of gamblers)

Secular Alternatives

SMART Recovery (Self-Management and Recovery Training)

Women for Sobriety

Rational recovery

sECULAR aa

Secular Organizations for Sobriety (SOS)

LifeRing Secular Recovery

Religious Alternatives

Celebrate Recovery

Christians in Recovery

Addictions Victorious

alcoholics victorious

Alcoholics for Christ

overcomers in christ

overcomers outreach

the calix society

jewish alcoholics, chemically dependent persons and significant others (jacs)

BUDDHIST RECOVER NETWORK

REFUGE RECOVERY

Additional Support Groups & Organizations

violence anonymous (VA)

Adult Survivors of Child Abuse Anonymous (ASCAA)

Survivors of Incest Anonymous

lds family services

porn addicts anonymous (PAA)

Sex Addicts Anonymous (SAA)

Sexaholics Anonymous

Sex and Love Addicts Anonymous (SLAA)

sexual compulsives anonymous (SCA)

Sexual recovery anonymous (SRA)

Co-dependents Anonymous (CoDa)

Emotions Anonymous

Dual Recovery Anonymous

Depressed Anonymous

social anxiety anonymous (SPA/Socaa)

PTSD Anonymous

Self Mutilators Anonymous

obsessive compulsive anonymous

obsessive skin pickers anonymous (OSPA)

Clutters Anonymous (CLA)

Overeaters Anonymous (OA)

Food Addicts Anonymous (FAA)

Food Addicts in Recovery Anonymous

Recovery from Food Addiction

Eating Disorders Anonymous (EDA)

Debtors Anonymous (DA)

Underearners Anonymous (UA)

spenders anonymous

Workaholics Anonymous

Gamblers Anonymous

internet & tech addicts anonymous (ITAA)

Online Gamers Anonymous (OLGA)

offenders anonymous

reentry anonymous

GROw in america (peer support for mental illness)

hearing voices network

AA Sites for agnostics and atheists: AA Agnostica and AA Beyond Belief

Image by Jill Wellington from Pixabay

Do you know of a 12-step support group not listed here? Share in a comment!

4 Strategies for Better Decision-Making

Individuals with “big picture” styles of reasoning make better decisions. Learn four strategies for “big picture” thinking to get optimal results.

By Cassie Jewell, M.Ed., LPC, LSATP

A recent study found that individuals with a “big picture” style of thinking made better decisions. (“Better” decisions were defined as those resulting in maximum benefits.)

If 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.

“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.

The following strategies promote “big picture” thinking:

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).

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. 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 on making that decision. 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!


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 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 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 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 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 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 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 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 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 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

Turner, A. D., Smith, C. E., & Ong, J. C. (2017). Is purpose in life associated with less sleep disturbance in older adults? Sleep Science and Practice, 1(1), DOI: 10.1186/s41606-017-0015-6

University of Michigan. (2009, June 3). Feeling Close To a Friend Increases Progesterone, Boosts Well-being and Reduces Anxiety and Stress. ScienceDaily. Retrieved July 18, 2018 from www.sciencedaily.com/releases/2009/06/090602171941.htm

University of Oxford. (2016, October 5). Being kind to others does make you ‘slightly happier’. ScienceDaily. Retrieved July 18, 2018 from www.sciencedaily.com/releases/2016/10/161005102254.htm

Zisberg, A., Gur-Yaish, N., & Shochat, T. (2010). Contribution of routine to sleep quality in community elderly. Sleep, 33(4), 509-514.

11 Self-Care Ideas You May Not Have Considered

(Updated 1/13/20) Self-care is a vital piece of the wellness puzzle. This post is intended for the well-informed “self-carer,” who already knows about (and maybe even practices) deep breathing, massage, aromatherapy, etc. and wants to expand their horizons. This is also for people (like me) who don’t get much from your typical self-care practices (i.e. lighting a scented candle).

By Cassie Jewell, M.Ed., LPC, LSATP

Self-care is a vital piece of the wellness puzzle. As a mental health professional, I practice self-care to prevent burnout. (Once a counselor reaches burnout, he/she is no longer able to fully meet a client’s needs; if you’re not taking care of yourself, how are you going to help someone else?)

To illustrate the importance of self-care, consider a vehicle; it requires ongoing maintenance for optimal performance and safety. Similarly, we require self-care. It’s a concept that encompasses a variety of needs, including health, solitude, human connection, self-love, spiritualty, and more.

I’ve read many articles, posts, and books on self-care; there’s a wealth of information out there. Commonplace self-care tips, such as taking a bubble bath or meditating, make up the majority of posts on the topic; but unoriginal content has no place here. And to be honest, some (okay, a lot!) of the ideas make me want to roll my eyes. (Lighting a scented candle? Nope, not gonna do it for me.)

This post is intended for the well-informed “self-carer,” who already knows about (and maybe even practices) deep breathing, massage, aromatherapy, etc. and wants to expand their horizons. This is also for people (like me) who don’t get much from your typical self-care practices.

Here are 11 unique ideas:

1. Create an inspirational scrapbook or a “bliss book” 

Any time you happen upon something that makes you smile, inspires you, or motivates you, add it to your scrapbook (or journal or binder). Maybe it’s a photo, a happy thought you jot down, or a magazine article. Alternatively, you could create a “bliss board” on Pinterest.

Creating a bliss book (or board) has the potential to generate positivity and compassion. Whenever you need an emotional pick-me-up, flip through your scrapbook. Share it with others to generate a double dose of cheer!

2. Plan a trip 

If you can’t take a vacation, you can at least plan! Preparation is half the fun (for me, at least)! Look up places you’d like to travel and research things to do there. Create an itinerary. Set a tentative travel date (even if it’s years from now) so you have something to look forward to.

3. Poop in public bathrooms (without shame)! 

If you’re one of those people who avoid going number 2 in public bathrooms, stop. Holding in your poop is uncomfortable and may result in constipation. If you’re embarrassed about the smell, carry a travel-sized container of Poo-Pourri. If it’s the sound that makes you anxious, run the water or flush as you go. When your body tells you it’s time to go, listen! 

4. Treat yourself to a monthly subscription box 

I love getting mystery packages in the mail! It’s akin to receiving a care package when you’re a kid at summer camp. And when it comes to subscription boxes, there are many to choose from. Currently, I subscribe to four: Ispy (5 makeup samples in a cute makeup bag for $10), PLAY! by Sephora (5-6 makeup samples for $10), Trendsend (5-8 clothing items and no styling fee!), and StitchFix (a mix of 5 clothing items, shoes, and accessories with a $20 styling fee – fee is deducted from total).

Subscription boxes are fun and a great way for me to build a professional wardrobe and to try new makeup products. (Disclaimer: I receive a referral bonus if you sign up for a subscription service via one of my links.)

5. Sort through childhood toys or photos

Allow yourself time to reminisce. My sister and I recently went through a box of old dolls and stuffed animals; it was the most fun I’ve had in a long time. It released a flood of happy memories and it felt great to laugh. (We chuckled over my Barbie dolls, which all had short, spiky hair; I was a very literal child, so when my sister declared “Barbie haircut day,” I took it to heart. My sister, on the other hand, only pretended to snip her Barbies’ hair. I cried rivers that day.)

I also enjoy looking at old family photos. See below for a pic from the year my mom went on a mission to create the perfect Christmas photo letter (the kind moms send out to impress relatives and old friends). “Fred the Christmas Goose” didn’t make the cut.

6. Create something

Practicing holistic self-care means stretching your mind; you benefit from the challenge. Avoid stagnation by stepping outside your comfort zone. Feed your creative side by building a chair, writing a song, painting a picture, knitting a scarf, or putting together a model.

Personally, I enjoy creating art; while not entirely lacking in talent, I’m no Picasso. Most of my projects are equivalent to the work one would accredit to a moderately talented 8-year old. Every once in awhile, I’m pleasantly surprised. (See below for a sketch I posted on Instagram.) Drawing or painting elicits a sense of accomplishment; it’s something I feel good about. Acknowledging your contributions builds self-esteem and confidence.

View this post on Instagram

@levgrossman

A post shared by Cassie Jewell (@cjewell82) on

7. Engage with a stranger, an acquaintance, a friend, or a family member

Establishing meaningful human connection is essential for wellness. To make the most of this tip, try something you normally wouldn’t. (For example, chatting with a stranger is not my norm. To practice this tip, I’d strike up a conversation with my seatmate on a plane [providing, of course, that they’re open to friendly conversation.) Practicing self-care means building (or strengthening) connections. 

8. Go exploring 

As a child, nothing thrilled my soul quite like adventure; I explored by trampling through the woods behind my house, traversing streams and following hidden trails. My adventures often involved the discovery of “treasure,” an odd rock or ruins of some sort. Today, I’m just as adventurous; however, I spend less time crashing through woods and more time traveling the world.

Exploration promotes curiosity, which is essential for growth. If you’re not a fan of outdoor activities like hiking or backpacking, try exploring a city or neighborhood. Consider driving through unfamiliar developments. Explore restaurants or shops in your town. Whatever you decide, pursue it with the enthusiasm of the 6-year old adventurer you once were.

9. Redecorate your office or a room in your home to make it soothing, energizing, or inspiring

Every time you’re in the room, you’ll experience positive vibes. Paint the walls, add plants, declutter, hang a portrait, change the curtains, create a rock garden, etc. – whatever promotes positivity.

10. Change something about yourself

There’s a lot to be said for loving yourself, flaws and all. On the flip side, if there’s something you’re extremely unhappy with, consider changing it. If you’re overweight and have tried every sort of diet, but still can’t shed those pounds, talk to a doctor about weight loss surgery or schedule an appointment with a plastic surgeon. If you’re tired of feeling sluggish and lacking energy, adjust your sleep schedule, diet, and exercise routine (and make sure you see a doctor to rule out a medical issue). If you’re constantly broke, get a second job or find another way to bring in income; enroll in financial courses or schedule an appointment with a financial advisor.

Sometimes, self-care involves drastic change. If you’re deeply troubled over some aspect of your life, and it’s something you’re unable to accept, change it (while recognizing it will require work!) This is your life; take action.

Note: This tip is only for things you have control over; recognize what you can and cannot change. For example, I don’t like my flabby arms; if this bothered me enough, I could lift weights to develop muscle tone. I also dislike my neck; it’s not long enough. Unfortunately, short of brass neck coils (which border on self-harm), there’s nothing I can do. It’s not worth brooding over. (That being said, when contemplating any major change, especially ones involving surgery or substantial amounts of money, ask, “Is this change for me alone or am I seeking outside approval?” The essence of self-care is the self; it’s for you and you alone.)

11. Adopt a healthy habit (or quit a bad one) 

This idea embodies delayed-gratification self-care vs. instant-gratification self-care (i.e. sipping a mug of tea or gazing at the stars). And while both types of self-care are important, the rewards associated with a healthy habit are life-changing (vs. “mildly pleasant”).

According to research, there are five lifestyle habits associated with a low risk of illness and longer life expectancy. If you’re serious about self-care (and want more bang for your buck), adopt one (or all) of the following practices:

Eat a healthy diet

Exercise regularly

Maintain a healthy body weight

Drink alcohol in moderation (or not at all)

Don’t smoke

A healthy lifestyle is the foundation of self-care!

Share your favorite strategies for self-care in a comment!


 

Sleep Deprivation: What Dreams May… Cure?

What happens to your mind and body when you’re sleep-deprived? Poor-quality sleep is linked to a variety of health conditions, including obesity and heart disease. Poor sleep leads to cognitive impairment and poor judgment. A lack of sleep can even lead to schizophrenia-like symptoms! Learn why sleep is essential for health and well-being.

By Cassie Jewell, M.Ed., LPC

According to the American Academy of Sleep Medicine, about 10% of Americans struggle with chronic insomnia and up to 35% of Americans experience insomnia at least occasionally. I’m part of the 10%. I’ve spent countless nights tossing and turning, dreading the obnoxious sound of “quantum bells” (my cell phone alarm) as daylight slowly creeps in. Due to this, I’ve done quite a bit of research on the subject. (And as a clinician, it’s important for me to know the relationship between restful sleep and mental health so I can educate my clients.)

Sleep recharges us; it makes it possible for us to remember what we learned throughout the day.

We all know that basic sleep hygiene is essential (i.e. having a regular sleep schedule, refraining from watching TV or reading in bed, avoiding alcohol before bedtime, etc.) And if you struggle with insomnia, you’ve probably heard of sleep medications and supplements like Ambien, trazodone, or melatonin. We also know how vital sleep is to health and wellness. Sleep significantly impacts mood, energy levels, and overall well-being. Sleep recharges us; it makes it possible for us to remember what we learned throughout the day.

Knowing how crucial sleep is for both physical and mental fitness, I set out to explore what happens when we don’t get enough. What exactly does a lack of sleep do to a person? I sifted through the research to learn more about the impact of sleep deprivation. This post explores how sleep deprivation affects physical health, perceptions, memory, and critical thinking.

SLEEP AND YOUR PHYSICAL HEALTH

Sleep deprivation is associated with signs of aging

Sleep deprivation has been linked to aging skin. One study found that poor-quality sleepers had more fine lines, uneven pigmentation, and reduced elasticity.

It makes sense that chronic sleep deprivation is associated with signs of aging; sleep is needed for overall rejuvenation (mind and body), which includes skin cell renewal. For smooth and supple skin, high-quality sleep is essential.

Snoring and sleep deprivation are linked to obesity

A 2016 study looked at the relationship between sleep characteristics and body size/weight. Snoring was associated with having a higher BMI, a larger waist, and more body fat. (It should be noted that snoring doesn’t cause obesity; the two are simply related.)

Poor sleep quality and shorter durations of sleep were linked to larger body size and more body fat. The relationship between sleep and obesity is further explored in the next few paragraphs.

Sleep deprivation is related to weight loss and appetite

If you’re dieting, you’re more likely to lose body fat when you’re getting adequate sleep. Researchers studied participants who slept for either an average of seven and a half hours or five and a quarter hours per night over a 14-day period. Calorie consumption was the same; participants lost similar amounts of weight. However, when participants slept more, they lost more body fat; in fact, about half of the weight they lost was fat. Sleep-deprived participants lost only a pound of fat; the other five pounds were fat-free body mass. Furthermore, it was found that sleep helps with appetite control; this is due to ghrelin, a hormone that stimulates appetite and promotes fat storage. Sleep-deprived participants had higher levels of ghrelin.

If you’re watching what you eat, incorporate healthy sleep habits to maximize your efforts; adequate sleep is needed for optimal weight loss.

Sleep affects our food choices

Other studies have examined specific the ways sleep deprivation affects food choices and calorie intake. Sleep deprivation is associated with especially poor food choices the day following poor-quality or no sleep. One study found that sleep deprivation led to strong cravings for junk food. The researchers measured increased activity in the part of the brain that responds to rewards, but decreased activity in the “decision-making” part of the brain. Study participants choose unhealthy items (i.e. pizza, donuts) over fruits and vegetables.

Another study looked at total calorie intake; sleep-deprived participants consumed an extra 385 calories per day. They also ate higher-fat foods. Additionally, researchers found that a sleep-deprived person purchased items that were higher in calories when grocery shopping.

A 2016 study looked at the relationship between sleep deprivation and the consumption of high-calorie, sugar-sweetened caffeinated beverages in a sample of 18,000 adults. It was found that adults who averaged less than five hours of sleep per night were more likely to consume sugary drinks like soda or energy drinks than their well-rested counterparts. The researchers weren’t able to determine whether drinking caffeinated beverages caused people to sleep less or whether being sleep-deprived caused people to crave more sugar and caffeine; it’s likely that both are true.

Without high-quality sleep, it’s difficult to lose body fat.

Regarding obesity, sleep deprivation plays a significant role. A lack of sleep causes us to feel hungry. We crave junk foods and consume more calories. At the same time, sleep deprivation promotes fat storage while decreasing our energy levels. Without high-quality sleep, it’s difficult to lose body fat.

If you struggle with chronic insomnia, make an active decision to make healthy eating a habit; you’ll be less likely to submit to your cravings. Visit the grocery store only when you’re well-rested. Know that you may not feel like exercising; practice determination. Be mindful to counter some of the health risks associated with sleep deprivation.

Sleep deprivation is related to heart disease, hypertension, and stroke (especially if you’re a woman)

In addition to obesity, sleep deprivation is associated with heart disease, high blood pressure, diabetes, and stroke. A lack of sleep takes a toll on the heart. In a recent study, researchers looked at 24-hour shift workers. It was found that sleep deprivation led to a significant increase in cardiac contractility, blood pressure, and heart rate. Furthermore, study participants experienced thyroid changes and an increase in cortisol (the stress hormone).

Research also indicates that chronic sleep deprivation and disrupted sleep are linked to an increased risk of developing or dying from coronary heart disease or stroke. Diabetes and hypertension are associated with sleep deprivation as well.

A lack of sleep may impact women more than men. Researchers found that women who got less than eight hours of sleep per night were at a higher risk of heart disease and other heart-related problems when compared to men who got the same amount of sleep.

Chronic sleep deprivation is related to reduced immune function

Have you ever noticed that you heal slowly or get sick more often when you’re sleep deprived? According to research, chronic sleep deprivation is associated with reduced immune function. If you’re not regularly getting at least six to seven hours of sleep, you’re more susceptible to illness. Your immune system won’t be as effective at eliminating viruses and bacterial infections.

Chronic sleep deprivation is associated with bone loss

Sleep even affects your bones. One study found that chronic sleep deprivation was associated with a loss of bone mass (in rats, at least). The rats underwent sleep restriction measures for three months. A lack of sleep led to significant decreases in bone density, volume, and thickness.

SLEEP AND YOUR BRAIN

Sleep deprivation is associated with increased pain sensitivity

The first part of this post examined sleep’s impact on physical health; the next half will explore how sleep affects the mind, including the way we sense and perceive the world around us. Research indicates that sleep deprivation and/or disruption increase sensitivity to pain. Interestingly, in one study, stimulants like caffeine had the ability to “normalize” the pain sensation (meaning it would feel the way it would with adequate sleep).

Sleep and chronic pain seem to be intricately connected, but the relationship is not fully understood; up to 88% of individuals with chronic pain report sleep issues and nearly 50% of individuals with insomnia have chronic pain..

A lack of sleep affects the way you hear and process sounds

In addition to the sensation of touch, sleep deprivation affects the perception of sound. A lack of sleep impairs central auditory processing (CAP). CAP is crucial for aspects of hearing such as language comprehension, identifying sounds, and recognizing patterns.

In one study, participants took a longer time identifying sounds after being deprived of sleep for 24 hours. It appeared there was a “transfer delay” (from hearing to identifying and then interpreting). To be effective, CAP requires alertness and concentration.

Sleep deprivation affects the formation of memories

We know that sleep deprivation causes cognitive impairment; the brain can only store so much information before it must recalibrate. During sleep, memories are encoded; the brain “consolidates” memories by strengthening them and transforming them from short-term into long-term memories. Without sleep, long-term memories can’t form. Short-term memories are lost and/or altered. Even procedural memories are impacted by sleep deprivation. A lack of sleep leads to forgetfulness and an inability to retain new information.

Sleep affects the way we interpret emotions

Sleep deprivation impairs your ability to interpret facial expressions. A recent study found that a lack of sleep made it difficult for participants to recognize the facial expressions of happiness or sadness. Interestingly, the ability to detect anger, fear, surprise and disgust was not affected. This suggests we’re biologically wired to recognize the emotions related to survival. The researchers hypothesized that the brain preserves functions that perceive life-threatening stimuli while sacrificing functions associated with empathy, bonding, and friendship.

“Real life” implications: If you’re majorly sleep-deprived, you could misinterpret the intentions of others, negatively impacting relationships with co-workers, family, friends, and others. Furthermore, you could read people wrong or miss important social cues; you might not respond appropriately or you could seem lacking in empathy.

When someone is sleep deprived, they’re slower to adopt another’s perspective

In addition to perception and memory formation, sleep deprivation impacts decision-making skills and thoughts, including the ability to accurately assess a situation.

If you have chronic insomnia, you might experience interpersonal problems.

In 2015, researchers hypothesized that sleep deprivation would impair the capacity to recognize sarcasm. Study results didn’t support the hypothesis, but the research generated an unexpected outcome. It was found that someone who was sleep-deprived was slower to adopt another person’s perspective. Implications? If you have chronic insomnia, you might experience interpersonal problems.

Sleep deprivation affects our moral judgment

Sleep deprivation affects moral judgment. In one study, participants were sleep deprived (awake for 53 continuous hours) and then faced with moral dilemmas. They had difficulty solving the dilemmas and making appropriate judgments. Other studies support this as well; a lack of sleep is related to decreased moral awareness. When you’re faced with a tough decision, especially one that involves ethics or morals, be sure to get adequate sleep. You can’t always trust your moral compass.

Sleep deprivation is linked to impaired decision making

Moral decisions are taxing if you’re sleep deprived… the opposite is true with risky ones. Sleep deprivation alters areas in the brain that assess positive and negative outcomes; sensitivity to rewards is enhanced while attention to negative consequences is diminished.

If you haven’t slept, tough decisions can wait.

Researchers found that when gambling, sleep-deprived individuals were more optimistic about their odds of winning. Another study found that sleep deprivation made it difficult for study participants to come to a quick decision when pressured. Sleep-deprived participants also made more mistakes. If you haven’t slept, tough decisions can wait.

A lack of sleep affects optimism

If you’re not getting enough sleep, you could lose your ability to remain positive-minded. Research indicates that individuals with insomnia have lower rates of self-esteem and optimism. In 2017, researchers found that sleep-deprived study participants were less likely to focus on positive stimuli. An inability to think positively is also a symptom of depression.

A lack of sleep can lead to schizophrenia-like symptoms

Sleep deprivation can lead to perceptual distortions, cognitive disorganization, and anhedonia (an inability to feel pleasure).In a 2014 study, participants experienced psychosis after staying awake for 24 hours. The sleep-deprived individuals reported attention deficits and being more sensitive to light, color, and brightness. They exhibited disorganized speech, which is a common symptom of schizophrenia. Participants also reported an altered sense of time and smell. Some of them actually believed they were able to read thoughts; others noticed an altered body perception. Implications? If you miss a night (or two) of sleep, don’t be surprised when you hear voices or when your reality is somewhat altered.

In conclusion, sleep deprivation, especially when it’s chronic, is detrimental to your health. Based on my review of the research, poor-quality sleep can adversely impact your skin, your weight, your cardiovascular system, your immune system, and your bones. (It should be noted that I barely skimmed the surface of an immense body of scientific data on sleep.)

Sleep is also related to brain health. Sleep deprivation impairs sensory perceptions, memory formation, the ability to assess your environment, moral awareness, critical thinking skills, and mood. Sleep deprivation can even induce psychosis.

If you’re like me (the one out of 10 Americans with chronic insomnia), in addition to practicing good sleep hygiene, go ahead and Google “CBT for sleep.” Research suggests that for some, CBT is more effective and longer-lasting than sleep medication. Do a little bit of research. CBT is not a quick fix for insomnia, but it’s worth a try; and your health and wellness are definitely worth it!

References

Alexandre, C., Latremoliere, A., Ferreira, A., Miracca, G., Yamamoto, M., Scammell, T. E., &, Woolf, C. (2017). Decreased alertness due to sleep loss increases pain sensitivity in mice. Nature Medicine, 23(6), 768–774. http://doi.org/10.1038/nm.4329

American Academy of Sleep Medicine. (2009, June 16). Cognitive Behavioral Therapy Is An Effective Treatment For Chronic Insomnia. ScienceDaily. Retrieved February 21, 2018 from www.sciencedaily.com/releases/2009/06/090609072709.htm

American Academy of Sleep Medicine. (2007, March 2). Sleep Deprivation Affects Moral Judgment, Study Finds. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2007/03/070301081831.htm

Cappuccio, F., Cooper, D., D’Elia, L., Strazzullo, P., &, Miller, M. (2011). Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies. European Heart Journal, DOI: 10.1093/eurheartj/ehr007

Chapman, C., Nilsson, E., Nilsson, V., Cedernaes, J, Rångtell, F., Vogel, H., Dickson, S., Broman, J., Hogenkamp, P., Schiöth, H., &, Benedict, C. (2013). Acute sleep deprivation increases food purchasing in men. Obesity, DOI: 10.1002/oby.20579

Deliens, G., Stercq, F., Mary, A., Slama, H., Cleeremans, A., Peigneux, P., &, Kissine, M. (2015). Impact of acute sleep deprivation on sarcasm detection. PLoS ONE, 10(11). e0140527. http://doi.org/10.1371/journal.pone.0140527

Diering, G., Nirujogi, R., Roth, R., Worley, P., Pandey, A., &, Huganir, R. (2017). Homer1a drives homeostatic scaling-down of excitatory synapses during sleep. Science, DOI: 10.1126/science.aai8355

eLife. (2016, August 23). How sleep deprivation harms memory. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2016/08/160823125219.htm

Finan, P., Goodin, B., &, Smith, M. (2013). The association of sleep and pain: An update and a path forward. The Journal of Pain: Official Journal of the American Pain Society, 14(12), 1539–1552. http://doi.org/10.1016/j.jpain.2013.08.007

Gharib et al. (2017). Transcriptional signatures of sleep duration discordance in monozygotic twins. Sleep, DOI: 10.1093/sleep/zsw019

Greer, S., Goldstein, A., &, Walker, M. (2013). The impact of sleep deprivation on food desire in the human brain. Nature Communications, 4 DOI: 10.1038/ncomms3259

Havekes, R., Park, A., Tudor, J., Luczak, V., Hansen, R., Ferri, S., Bruinenberg, V., Poplawski, S., Day, J., Aton, S., Radwańska, K., Meerlo, P., Houslay, M., Baillie, G., &, Abel, T. (2016). Sleep deprivation causes memory deficits by negatively impacting neuronal connectivity in hippocampal area CA1. eLife, 5 DOI: 10.7554/eLife.13424

Johns Hopkins Medicine. (2017, February 2). Sleep deprivation handicaps the brain’s ability to form new memories, mouse study shows: Chemical recalibration of brain cells during sleep is crucial for learning, and sleeping pills may sabotage it. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/02/170202141916.htm

Khatib, H., Harding, S., Darzi, J., &, Pot, G. (2016). The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. European Journal of Clinical Nutrition, DOI: 10.1038/ejcn.2016.201

Killgore, W., Balkin, T., Yarnell, A., &, Capaldi, V. (2017). Sleep deprivation impairs recognition of specific emotions. Neurobiology of Sleep and Circadian Rhythms, 3(10) DOI: 10.1016/j.nbscr.2017.01.001

King’s College London. (2016, November 2). Sleep deprivation may cause people to eat more calories. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2016/11/161102130724.htm

Knutson, K. (2012). Does inadequate sleep play a role in vulnerability to obesity? American Journal of Human Biology, 24(3), 361. DOI: 10.1002/ajhb.22219

Liberalesso, P., D’Andrea, K., Cordeiro, M., Zeigelboim, B., Marques, J., &, Jurkiewicz, A. (2012). Effects of sleep deprivation on central auditory processing. BMC Neuroscience, 13(83). http://doi.org/10.1186/1471-2202-13-83

Mitchell, M. D., Gehrman, P., Perlis, M., &, Umscheid, C. A. (2012). Comparative effectiveness of cognitive behavioral therapy for insomnia: A systematic review. BMC Family Practice, 13(40). http://doi.org/10.1186/1471-2296-13-40

Perelman School of Medicine at the University of Pennsylvania. (2017, July 17). You’re not yourself when you’re sleepy. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/07/170717120048.htm

Petrovsky, N., Ettinger, U., Hill, A., Frenzel, L, Meyhofer, I., Wagner, M., Backhaus, J., &, Kumari, V. (2014). Sleep deprivation disrupts prepulse inhibition and induces psychosis-like symptoms in healthy humans. Journal of Neuroscience, 34(27): 9134 DOI: 10.1523/JNEUROSCI.0904-14.2014

Prather, A., Leung, C., Adler, N., Ritchie, L., Laraia, B., &, Epel, E. (2016). Short and sweet: Associations between self-reported sleep duration and sugar-sweetened beverage consumption among adults in the United States. Sleep Health, DOI: 10.1016/j.sleh.2016.09.007

Radiological Society of North America. (2016, December 2). Short-term sleep deprivation affects heart function. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2016/12/161202100943.htm

Universität Bonn. (2014, July 7). Sleep deprivation leads to symptoms of schizophrenia, research shows. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2014/07/140707121415.htm

University Hospitals Case Medical Center. (2013, July 23). Sleep deprivation linked to aging skin, study suggests. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2013/07/130723155002.htm

University of Arizona. (2017, March 23). Sleep deprivation impairs ability to interpret facial expressions. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/03/170323132524.htm

University of California – Berkeley. (2013, August 6). Sleep deprivation linked to junk food cravings. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2013/08/130806145542.htm

University of California – San Francisco. (2016, November 9). Shorter sleep linked to sugar-sweetened drink consumption: Treating sleep deprivation could potentially help reduce sugar intake. ScienceDaily. Retrieved March 8, 2018 from www.sciencedaily.com/releases/2016/11/161109112553.htm

University of Chicago Medical Center. (2010, October 5). Sleep loss limits fat loss. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2010/10/101004211637.htm

University of Warwick. “Lack Of Sleep Could Be More Dangerous For Women Than Men.” ScienceDailywww.sciencedaily.com/releases/2009/07/090701083523.htm

University of Warwick. (2011, February 8). Sleep deprivation: Late nights can lead to higher risk of strokes and heart attacks, study finds. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2011/02/110208091426.htm

University of Washington Health Sciences/UW Medicine. (2017, January 27). Chronic sleep deprivation suppresses immune system: Study one of first conducted outside of sleep lab. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/01/170127113010.htm

Washington State University. (2017, December 20). Seeing gene influencing performance of sleep-deprived people. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2017/12/171220153055.htm

Washington State University. (2015, May 7). Sleep loss impedes decision making in crisis, research shows. ScienceDaily. Retrieved February 21, 2018 from www.sciencedaily.com/releases/2015/05/150507165432.htm

Whitney, P., Hinson, J., Jackson, M., &, Van Dongen, H. (2015). Feedback blunting: Total sleep deprivation impairs decision making that requires updating based on feedback. SLEEP, DOI: 10.5665/sleep.4668

Wiley. (2013, September 5). Sleep deprivation increases food purchasing the next day. ScienceDaily. Retrieved March 6, 2018 from www.sciencedaily.com/releases/2013/09/130905113711.htm

Wiley-Blackwell. (2012, April 17). Lack of sleep is linked to obesity, new evidence shows. ScienceDaily. Retrieved March 10, 2018 from www.sciencedaily.com/releases/2012/04/120417080350.htm

Xiao, Q., Gu, F., Caporaso, N., &, Matthews, C. (2016). Relationship between sleep characteristics and measures of body size and composition in a nationally-representative sample. BMC Obesity, 3(1).

Xu, X., Wang, L., Chen, L., Su, T., Zhang, Y., Wang, T., &, Zhang, Y. (2016). Effects of chronic sleep deprivation on bone mass and bone metabolism in rats. Journal of Orthopedic Surgery and Research, 11(87). http://doi.org/10.1186/s13018-016-0418-6

Guest Post: You Don’t Have to Exercise

Exercise is a choice. Trevor Jewell, a certified personal trainer, explains that while you don’t have to exercise, you should definitely consider it.

By Trevor Jewell, ACSM Certified Personal Trainer

You will definitely get more gratification from grabbing a pint of ice cream and putting your feet up for a Netflix binge. Obviously, we don’t exercise because we have to. No one is holding a gun to your head while you sweat and gasp for air in a crowded gym as the seconds of your life tick away on a treadmill timer. We exercise because we want to! We want to feel good, look good, and live long and happy lives free of pain and injury, so exercise becomes worth it.

Image by Sabine Mondestin from Pixabay

Many of my clients have told me during their consultations that they don’t like exercise. Cardio is boring, weights are intimidating, ab work hurts too much, the list goes on and on. But all of them, every single one, enjoys the feeling of having completed a tough and energizing workout. The important difference is, after discussing their goals, they have input on their workout plan in the form of choice.

Hate cardio? No problem! I’ll offer you routines with moderate intensity interval training that mimics the aerobic effect of jogging. Weightlifting too intimidating? We’ll try out different bodyweight routines that incorporate resistance training without ever touching anything but the floor. Ab work hurts? How about a few functional fitness games that utilize your core without shredding it like an 8 minute ab routine from Women’s Health magazine. For my advanced clients, I plan days where they get to use what they’ve learned and choose their own workouts while I simply help align their choices with their goals and provide coaching as needed.

Image by Joanna Dubaj from Pixabay

The point is, almost everyone performs better in an environment where they don’t feel trapped and locked into a routine. This is why hiring a personal trainer can be a truly liberating experience as people realize they never have to touch an elliptical again if they don’t want to, but can still lose weight! If you are dragging your feet on the way to the gym to half-heartedly complete yet another round of the same old routine, it’s time to incorporate more choice into your workout.

It should come as no surprise that freedom of choice can lead to better results outside of the gym as well. In a recent study published in Medicine & Science in Sports & Exercise, scientists discovered a direct link between having choice in a workout and making healthier diet selections. Two test groups were given instructions to exercise and then allowed to eat at the same buffet. One group was forced to complete an exact routine, while the other was allowed to choose their type of exercise, starting time, and even background music. Upon reviewing their trips to the buffet, the authors discovered that those with more choice in their workouts consistently ate less calories (587 versus 399 kcal) and chose healthier foods than their counterparts!

Image by 272447 from Pixabay

If you’ve ever piled three extra slices of pizza on your plate as a reward for going to the gym that morning, you know exactly how the “forced” participants were feeling. Treating an exercise routine as something you have to “get out of the way” or “get over with” will cause you to feel trapped, and to disassociate your workouts with your life. Our goal as personal trainers is not to force people to get healthy, but to get them to associate an energizing workout in the gym with the overall goal of a healthy lifestyle. We don’t have to exercise, we choose a higher quality of life, and have fun doing it!


Trevor Jewell is an ACSM Certified Personal Trainer with EnDevor Health: Connecting doctors, exercise physiologists, and personal trainers to truly implement Exercise is Medicine in patients’ lives, located in Columbus, OH