 Again, I would like to welcome everybody to today's class, 101 Mindfulness Exercises for Children and Adolescents. Of course, we're not going to hit all 101 in this particular hour overview. I am going to hit some of the exercises that I liked the most. I really do like this book as far as a book that's out there that gives you a lot of practical activities that you can use in individual or group. You can get it on Amazon if you want to, or you can just use this for a learning experience as we go today. Over the next 45 minutes, we're going to explore activities that can help adolescents and children connect with core mindfulness, walking the middle path, distress tolerance, emotion regulation, interpersonal effectiveness, and then we will also talk about other miscellaneous mindfulness exercises and DBT games and activities. One of the things that we find, and developmentally, it just makes so much sense, children are very polar in their thinking. They can, it's black or it's white, it's right or it's wrong. There's no gray area, so as they grow older, it's part of it's up to us to help them see the middle ground, to help them rectify the two dialects or walk the middle path, if you will, if you want to use the words from this presentation. Now, we're going to talk about these in terms of activities that you can do with children and adolescents. Why am I going to focus on that? Because what you can do with children and adolescents, you can also often do with adults with a few minor modifications. But what you do with adults, you can't necessarily do with children and adolescents because they'll find it hokey or it may be developmentally kind of beyond where they are. If you start talking about things that are really esoteric, some kids will just kind of look at you with that confused German Shepherd look on their face. Right now, we're going to focus on things that are a lot more generalizable, longitudinally, across your age groups. So, remembering in core mindfulness, there are three states of mind, reasonable, which when you talk with children, you can use words like it's your school brain or your scientist or think like a robot. This is the mind that doesn't have a lot of emotion. If they're into television, you can maybe make the analogy between that and data who was on Star Trek Next Generation. That may be your older adolescents who are Trekkies. Understanding them, understand that this reasonable mind is separate and distinct from what's the emotional mind. The emotional mind can be conceptualized as kind of what your heart says. A lot of times when we are acting emotionally, it's coming from the heart. Sometimes when I'm working with adults and adolescents, I will ask them if they're getting stuck on articulating what they're feeling, I'll ask them what would your heart say? Sometimes that's easier than trying to figure out what they're feeling because feeling is different than saying. Basically talking about different learning styles, but it's another way to approach it. The wise mind is the logical choice that makes you as happy as possible. When I'm working with kids, a lot of times I will come in and we'll talk about examples. Tell me about a time where there was something that happened that your reasonable mind or your school brain told you was one way, but your emotional brain told you it was another way. I give my example of animal rescue. My scientist brain says there's only so many hours in the day and there's only so much you can do with animal rescue. There's always going to be another homeless animal. You can't rescue them all and wearing yourself down doesn't help you help other animals. My emotional brain, my heart says I can take one more puppy. What's one more puppy? It's just a matter of getting it ready for adoption. The wise mind kind of puts it together and goes, you've got a balance. Going back to your acceptance and commitment therapy, what is going to get you closer to where you want? Yes, I want every animal in the world to have a home and get all that happy stuff, but my kids are also important. My job is also important. If I devote all of my energy and I get completely burned out by taking on too much animal rescue, then I can't devote time to other things that are important. Another example would be for kids that may strike home a little bit more would be extracurricular activities. Maybe they want to engage in a lot of extracurricular activities and those are fun. Don't get me wrong, but at a certain point you have to have enough time for homework and chores and whatever else your parent expects you to do. Your heart says, I really want to play on the football team and I really want to do this and I really want to do that. The wise mind says, in order to do these things, mom or dad is going to have to tote me from here to there. I have to make time for other things, so I need to pare it down and choose from these activities so I can do things I want to do, but I can also get the things done that I need to do. Talking about the three states of mind and sort of starting to hedge toward walking that middle path, with non-threatening examples I find with children especially and I use the term children to mean anybody under 18 because that's where I'm at, but working with them, if you start with non-threatening examples, nothing that's too terribly personal, it tends to go over more easily. They're willing to talk about it. They're willing to provide suggestions, so I might throw out something else that like there's a school dance coming up and you want to go, so let's talk about the reasonable mind, let's talk about the emotional mind, and then let's talk about the wise mind. Or I might throw out something that is a current issue in the news, try not to take anything too emotionally charged, but something that they might be interested in and care about. Wise mind, what skills? When you're in your wise mind, when you're being a detective, the first thing you need to start asking is what? You want to observe and be a detective and take in the whole situation. So this is an activity in and of itself. Put them in a room, give them five minutes, have them take in as much as they can and then have them all talk about what they saw in that room. You can take them outside and you can do the same thing. You can give them an object, such as one of the things that I had to do during one of my first teaching classes. They gave us a pencil and they're like, describe this pencil to the class. And we had three minutes, three minutes. We had to spend describing this pencil. That's a little bit excessive, but it does encourage you to start looking at a lot of the different characteristics of things and observing. Describing, naming your experiences, what's going on with you right now? Is it a good experience? Are you comfortable? Are you uncomfortable? And then participating, being actively involved in the moment. Sometimes we'll get together and I'll set up a scene, kind of like a crime scene. And I will have them work together to try to figure out what happened, sort of kind of like a game of Clue, in order to be actively involved. They're all observing. They're all making interpretations of what they observe. And then we start talking about the differences in interpretation. Why was the knife all the way across the room? How could it have gotten there? And people generally have different hypotheses. So we start describing that as we move on to taking different perspectives in a personal communication. It can be fun. So we want to have people practice observing, describing, and participating. If you Google these things online, activities for observing, describing, and participating, you can come up with a lot of them. Another thing you can just do is think of what would you find entertaining or amusing if you were going to be doing this activity? Discuss things that would stay in the way of observing, describing, and participating. So if you were trying to figure out what was going on, and maybe you were there, but there was somebody else that was sort of threatening, or you didn't want to be look foolish in front of someone. So that may make people back off. You know, maybe it's a boy they like or a teacher or a parent. So there may be some things that stand in the way of them observing the whole situation. So you want to talk about that in terms of something non-threatening. But then eventually we'll start talking about it in terms of when there's an upsetting situation, what gets in the way of you observing what's going on and figuring out all the what's. What's going on here and describing how you're feeling and participating in this whole process. A lot of times people who have high levels of emotionality have been invalidated and shut down so many times that that stands in the way. They don't even want to open up to somebody else because they don't want to feel invalidated again. So we start talking about what that looks like and how to create a situation where it would feel safe to observe, describe, and participate. Now the how skills were still in this detective mode. So how did we get there? And observable, measurable, non-judgmental explanations for what may have happened. I know I just used what instead of how. How did this happen? How did we get to this point? We want to encourage people to focus on the task at hand and clear their mind of anything else when they are working in the crime scene scenario. A lot of times they're not focused on anything else because it's fun. When they're working on something else, maybe a test, which tests can provoke a lot of anxiety. They may also be focusing on what their parents are going to say and what's going to happen if they fail this test, maybe they'll be benched from the football team or the cheerleading squad. So we want to encourage them to use their wise mind to focus on a task at hand because the detective is not distracted or ideally. And then we want them to do what works. They know what's worked for them. When they've had a stressful event before, what's worked for them? Let's focus on their strengths instead of saying, okay, so let me teach you all these new things. And, you know, if you happen to know something else, goodie for you. I want them to bring those skills into the room so we can all share them and go, hey, that's a great tool. It opens minds of communication. Again, if you start talking about something relatively non-threatening like public speaking or asking somebody out or taking a test, things that they've all done, but it doesn't put any one person really on the spot, then they can talk about how they've controlled their anxiety, how they've controlled their emotions, that there's been a rejection or they don't feel. So once they've observed, then we want to start helping them balance the ideas of acceptance and change. They've observed it. They may not like it or they may. It doesn't really matter. It just, it is. And the cool thing about DBT is understanding that what is right now is going to change. So it may really suck right now. And it feels like your heart is going to burst out of your chest. But when you felt like that before, have there been, has it dissipated? Has it changed? And over time, it didn't feel so bad. It will change. So how can we expedite that process? How can we help you cope? And how, again, do what works? How have you done that before? Walking the middle path is when we start talking about incorporating the dialectics. It's both and. Thinking, and this is not an example I use with my adolescent groups because it's a little kind of more out there. I'm just using it for teaching. A child who's been abused. That child says, my parent loves me, but my parent beats me. I don't understand how can they love me and hurt me at the same time. Incorporating that both and maybe they love you and they have issues controlling their own feelings and behaviors when they get upset. Does that excuse it? But does it, because they beat you doesn't mean they don't love you, not necessarily. So we want to look at, is there a way that you can rectify this? And it's a both and. Yeah, sucky things are happening, but there's also some good stuff. Recognizing that the change, that changes the only constant. So if you have a parent that's like that, maybe they had a substance abuse problem. And when they were behaving aggressively was always when they were under the influence. As the person gets older, they can set boundaries. So they're not around that person when that person's aggressive. As they get older, that person may change and not act out as much. There's a lot of things that are going to change in that relationship. They're probably going to be stuck with that, those dialectics from childhood that said, I can't rectify them hurting me and loving me. So once they get into adulthood and they can start looking at the middle path, we can start talking about that. This is something that I talk about a lot, unfortunately with younger children when they come to family education for substance abuse. How can my parent love me and choose to go out and use alcohol or drugs and get arrested? How does that work? Aren't they supposed to be there for me? Yeah. However, let's look at are they doing this because of you? Validation. We want to validate how they're feeling. Yeah, it's awful. And it really hurts when they choose methamphetamine over you. So using your active listening counseling skills, teaching them to tolerate others as they are in the moment. And one of the things that phrases that I use a lot is just repeat to yourself that so-and-so is probably doing the best they can with the tools they have at this point in time. Helping them find something they can tell themselves so they can tolerate what seems intolerable at the moment. And tolerating themselves when they feel like they're angry, when they feel terrified, when they feel resentful. Instead of criticizing it or judging it and saying, I shouldn't feel this way, just tolerating the fact that this is how I feel. And then walking the middle path also incorporates behaviorism. Reinforcement of times when the person starts to look at that gray area, starts to combine both ends of the spectrum. We want to say, yeah, exactly. This is how these two things can technically co-occur. Shaping. We want to encourage people to start looking at the dialectics. We want to help people start looking at combining what their rational mind tells them with what their emotional mind tells them. It's not going to happen overnight. You're going to see small changes. You may see them hypothesize a little bit, but then go back to the old way of thinking. And that's okay. Let them dip their toe in there. I'm just proud that they even tried to figure out how these two things might work together. I'm not going to criticize them or be hypercritical of if they're being intolerant of others or themselves, but we will talk about it. And I don't tell them they can't say should, but we really do want to look at the implications of if I shouldn't feel that way. Who says you don't want to feel that way is different than you shouldn't. So who says you shouldn't feel this way? And we want to extinguish maladaptive behavior. So when they start to get upset, you know, generally they're feeling overwhelmed and the emotions are completely just intolerable. And yeah, feeling like you are going to absolutely suffocate in your own emotions and wanting to survive at the same time. Two different ends of the spectrum. How do you bring those together? So we're going to talk about how to make that happen. And we're going to talk about extinction of these maladaptive behaviors. Great. You didn't cut or you didn't drink or you didn't, you know, whatever the maladaptive behavior is. What did you do instead? And it may not be and it usually isn't at the beginning the best option. But if they're choosing something less harmful on, you know, think about a stairway. One being self injurious behaviors when they come in for treatment and 10 being the end of treatment where they are just fully functional, wonderfully self actualized human beings. I just what does it take to get them from a one to a two where I don't have to worry about their safety and they don't feel like they're in danger of hurting themselves. This is what we're going to reward. And then once they're stable in that, once they're able to do that regularly, we'll move on to the next thing. And we can use metaphors and visual metaphors of stair steps as well. Walking the middle path helps people open their eyes to seeing things from different angles. So again, going back to the crime scene, we may act out a situation or we may show video, video clips of a television show. And then I'll stop it and I'll say, okay, I want you each to take a character and tell me what you just saw happen. And we get different perspectives. So then we start talking about how do we put all those perspectives together to make something meaningful to the person. Remembering that change is constant and if it's stressful now change change will happen. I encourage them to find both sides of the spectrum and use a both and approach. So what's the worst possible explanation for this and what's the best possible explanation for this? And how can we put them together? Validating themselves, acknowledging what they feel non-judgmentally just, you know, I feel anxious. I feel angry. I feel happy. Or I feel nothing. Some people get angry with themselves because something happens and they feel like they should be upset. But they aren't. And they're like, well, I don't get it. And there must be something wrong with me. So we talk about the fact that that's just how you feel. And we encourage them to validate each other. Say, yeah, that's a good idea or I hadn't thought of it that way. If they have differing opinions talking about how to respectfully disagree. You know, if they totally can't take that and go, yeah, that's an interesting point of view. And be okay with that if they have to disagree. How can they do it respectfully? Distress tolerance will put up a flip chart paper. And I will put up a flip chart paper for each one of these for accepts activities contributing comparison emotions pushing the experience from your mind talking about or thinking about alternate things and sensations. Put those up around the room. Break the group up and they move from station to station. They have 30 seconds at each station to identify things they could do to help them tolerate distress. So what would they do for activities? What would they do for contributing, which is like volunteering? Or and it's not necessarily volunteering like at a soup kitchen. It could be volunteering to help your parent. My daughter was going through some stuff a couple weeks ago. And she stuck to me like glue. She hadn't followed me around that closely since she was four. And finally I was like, are you sure you don't want to do something else? And she's like, no, you know, I'm going through this other stuff here and it just helps me to stay busy right now. So I want to help. I was like, okay, well, cool. Because she's actually a very big help. Comparison comparing yourself to someone who is coping at least as well, or maybe even not so well. So it's at least I'm doing better than this isn't my favorite one to put up there, but it is an option. Emotions, bringing out the opposite emotions. Now it can be through TV, it can be through music, it can be through anything. So if somebody is angry, what's the opposite emotion? Happy, you know, happy just kind of is generally the opposite emotion. So what types of things make you happy? And I have them list them. Why do we do this in a group? Because people share different ideas and it also gets them talking among each other. They're like, oh, I didn't know you liked that band or really tell me about that movie. I haven't seen it. It encourages that interpersonal communication and connection and all that stuff we want them to talk about. But it's still in a non-threatening sort of way. They're not putting all their stuff out there. They're talking about things that they like to do. Well, how cool is that? Pushing the experience from your mind. When you want to stop thinking about something for a while, what do you do? And it's different for everybody. And I find that the more people you can get together, the more different, really good ideas come out. And a lot of times I'll get one or two things that I hadn't thought of or been exposed to before. And I'm like, cool. Think about alternate things. What other things can you think about? Guided imagery. Are you going to think about going on a vacation? Are you going to think about what other things would you want to think about when you're really angry or sad? And intense sensations. Now, when I'm working without lessons, a lot of times really loud music is high on their chart. Hey, it's high on my chart, so I can't really knock them for that. But experiencing really intense sensations can sometimes jar people out of a specific mood state. Holding ice cubes is another one. Taking a really hot bath. That could be another one or a really cold bath, but I'll take the hot one. Thank you. What else could they do? When I get really upset, sometimes I will go out and I will run as hard as I possibly can. And that sensation of breathing so heavy you think you're going to puke. It kind of gives you something else to focus on besides being upset. And then when I'm done, not only do I have an endorphin rush, but I've also had a mental break. So we put those things out there and we talk about it. What's healthy, what's not healthy, sometimes a few not so healthy things creep in there like eating. And we talk about how that's a stopgap, but it's not necessarily the best solution in the long term. Self soothing with the five senses. Identifying five things you see, four things you hear, three things you smell, two things you feel and one thing you taste. That can kind of help. And there's a lot of, again, if you Google this, there are a lot of different activities and it's also on my Pinterest board for mindfulness. There are a lot of different handouts that go over the five senses self soothing. This is not a new activity. One thing they talk about also is the pros and cons. Now, when you really look down at the pros and cons, it's basically just a decisional balance exercise. The long term goals, what are the pros and cons and of making it through this situation? What are the pros and cons of not making it through this situation? Yeah, the pain stops sooner. However, you may not have an opportunity to engage in other pleasurable situations. So we talk about those. We talk about the benefits and drawbacks of some of these new skills that we're learning. Yeah, they're hard. And sometimes they don't work as well as you would have hoped they would, but sometimes they do. Distress tolerance. Imagery of a relaxing place. And one of the things that I'll do with my groups is I'll put up on a whiteboard. I like whiteboards on visual. That's just me. Some people will use an audio recording that walks people through a guided imagery meditation. And that's great. You know, if that's works for your group, that's awesome. I talk about, you know, let's go to the woods or let's go to the beach and I'll put that up on the whiteboard. And then I write down each sense, you know, seeing, feeling, touching, all of them. And we talk about, okay, you're at the beach. What do you see? And each person shares what they see. And we go around and we keep sharing what we see for five minutes. Obviously, this isn't a group of like 12. If you have a group of three, it's probably going to be a shorter duration. Then we move on to smell. And as they start talking about what they smell, you might pick up on things that they might ought of should have seen. You know, if they smell, if they're at the beach and they smell a dead fish, you know, sometimes odd things come up. I'm like, okay, smell a dead fish. But we didn't talk about seeing that. You know, I might go back to site and go, did you see a dead fish? Yes, no, you know, this is your imagery. It helps them brainstorm and it helps them focus. A lot of times adolescents aren't good at walking themselves through a guided imagery lying in the bed going, okay, I'm going to my happy place. But if they create a worksheet, like the one we're doing on the board that has the different senses, they can start writing those things down. In the process of doing that, they're focused on the task at hand, not the emotional turmoil. We want to help them figure out how to get meaning in a situation. You know, maybe something happens. They ask somebody out and they get turned down and they feel devastated, embarrassed, humiliated, a whole wealth of emotions. They're not going to sit down and start writing their guided imagery right then in the hallway at school. So what else could they do? How have they survived similar situations? And if they're going into a situation where they know there may be the risk of stress, I want them to think about this ahead of time. So if they say yes, great. If they say no, how have you survived similar situations and how will you survive this one? And what's important in your life? In comparison, how important is this? So, you know, you ask somebody out to prom, they say no. In the big scheme of things, in comparison to other things in your life, is this the be all end all? This is obviously a question that's a little bit more geared towards your older adolescents. Your younger children are going to have a harder time identifying what's important in the big scheme versus today. Prayer, if it works for them, great. Whatever they want to define as prayer. I'm not going to be, I try to be as unspecific as possible unless I happen to know that I'm working with an entirely religious group. Relaxation activities. What could you do? One thing in the moment, focusing on one thing. It's just like, okay, when I think I've shared with you guys before, I have this irrational fear of bridges. And when I go for bridges, it's just, oh my gosh. So I focus on one thing, something in the car, something ahead of me, maybe the red car that's driving in front of me. And I start describing it to myself. Or I'll start saying the ABCs if there's nobody in front of me, because whatever it takes to get through the moment. But I'm focusing on the song at that particular point in time, which keeps me from getting all term oily until I get over the bridge. And I share these things with my adult clients as well as my adolescent clients, because I think it's important that they know we're human too. Take a vacation. It can just be a mental vacation. It can be a five minute mental break where you're just like, okay, I'm going to check out. Or it can be a physical vacation where you actually say, you know what, today I need a mental health day. That's something we've got to model for our kids. Obviously as clinicians, they only see us once a week, so it's not something we can really model for them. But we do want to encourage them to look at their options when they start feeling vulnerable. And making encouragement or helpful statements about themselves and others. So if they start feeling like they're being critical. And I encourage them to keep a diary or a journal log of unhelpful statements they've said about themselves, you know, generally in their own head, not to anybody else. Unhelpful statements they've said about themselves and unhelpful or critical statements they've said about others. And then we revisit those. A lot of times this is something that I'll do an individual not in group counseling. When we talk about people's specific statements and what helpful statements they could have put in instead. In group, I will give examples of unhelpful statements. For example, this line is taking forever to get through this cashier is ridiculously slow. Well, that's not helpful. That's not helping anybody is just using extra energy. A helpful statement would be, I wonder what I could do in order to make this person's job a little easier. Or it looks like they must be having an exhausting day. What can I do when I get up there, you know, smile, say hi, act the opposite. You know, if you're feeling angry, smile and try to bring some levity, if you will, to the situation. The helpful statements activity go in with a preprinted list of unhelpful statements. And ideally on the flip side, a list of helpful statements. So you're not bringing out or encouraging them to be critical of one another. Make it general. Radical acceptance, life can be tough and it isn't fair. And when we do our check-in, as we go around the group, as soon as group starts, I ask how people are doing and what's going on and things happen and they may be devastated. Or, you know, maybe somebody got the lead role in the school play and that was what they were just, they know that they were much better than that person, but they didn't get chosen for the lead role. And there's all kinds of reasons they didn't get chosen. We can't change any of those usually. So we kind of go back to, that's not fair and it sucks. And I acknowledge it. I validate it. And then we kind of move on and don't dwell on that situation in the group setting. Obviously, unless it's crisis-oriented. Some things can't be changed. I will give examples of things that can't be changed. Life can be tough. It isn't fair. I'll also give examples of that when we initially do the lesson. You get up in the morning and it's raining outside and you're supposed to, you're supposed to work outside all day or you have a big date this evening and it's pouring down rain. So now you're going to be soaked like a wet rat. Well, that can't be changed. What can be changed? You can choose something else for your shoes. You can reschedule, you know, you can change other things around it. But the person or the situation itself may not be changeable. And you don't have to like it. Maybe you don't want to go to school today or maybe you don't want to go to work today. Yeah, we all have days like that and you don't have to like it, but sometimes you've got to do it. I feel that way about going to the doctor sometimes like, I don't want to go to the doctor. But it's important to do to stay healthy. And in my ultimate goals and, you know, being healthy and there for my kids and all that happy stuff, I need to stay, take care of myself. So going to the doctor is sort of a necessary evil. We will identify, again, I'm a huge fan of flippy charts because I find when adolescents have to sit in a circle and be still and look at me, it feels much too much like a classroom to them. So I get far less participation than if I break them up into small groups. So we have things you can change and things you cannot change. And then we'll talk about the things you cannot change and how to make those workable or livable or dealable. Maybe they don't, their parents are divorced and they don't want to go visit their non-custodial parent. You may not be able to change that. But what things do you have control over? Emotion regulation, helping them understand that emotions are not just one. Emotions are complex. Generally, if you're angry, there's some fear under there. There may be a little resentment. There may be a little, who knows? So we talk about all the different kinds of emotions. One of the things I love to do is put all of the emotions, or 15 or 20, on little things in a hat. And I have them draw the emotions out and act them out, do charades. So what does angry look like? What does distressed look like? You get the idea. And you can take one of those feeling sheets that has all the little happy faces on them, not necessarily happy, but the little faces, the little icons. And you can cut that up. So they at least have a little icon to give them idea of what they may be looking at. I also encourage them, and sometimes I'll throw some feelings in there like nauseous. What does nauseous look like? And then we'll talk about what types of emotions might make you feel nauseous. Because remember, whenever you have an emotion, there are thoughts and physical sensations that go with it. One of the acronyms for emotion regulation is strength. It goes back to those vulnerabilities we've talked about. In order to regulate your emotions and in order to be able to keep all those things kind of in alignment and have your neurotransmitters balanced and stuff, you need to get enough sleep. Take care of yourself, not burn yourself out, not wear yourself down. Resist unhelpful behaviors or impulsivity, and this could be self-harming behaviors, or just unhelpful behaviors like getting angry and stomping off and slamming the door and things that are not going to resolve the situation. Exercise, for a whole lot of reasons. We talk again about different ways of exercising. You don't have to go to the gym, you don't have to run, you don't like to run, don't run. What can you do to exercise? You can garden, you can dance like a crazy person in your room, you can another one of those brainstorming activities. Anything you can do to move around. Exercise is merely moving. Even going to the mall and walking through and window shopping. Exercise, nutrition. Three colors on every plate, especially with kids and adolescents. They're not usually really into counting macros and everything, and I don't want them to feel bogged down by it. But I do encourage them to eat something that is a color other than brown or white. Gain mastery. Find things that you're good at, or find things that you want to be good at, and practice them, learn them, learn a new skill. Take time for yourself for relaxation and pleasant activities every day. It's not just something that, oh, I'm feeling really burned out, so I need to take a mental health day. We need to encourage, both by modeling and by talking about it and encouraging it in the kids, that they take time out for themselves every day. They have 30 minutes. What did you do for yourself for relaxation? And healthy self-talk. Oh, going back to taking time for yourself. One thing that I found with, especially if you're working with kids who have a history of abuse, there are certain words that are going to be trigger words for them. So when you're working with somebody, if you use the words pleasurable and the word enjoy have typically been hot button words that I found occasionally will set people off. Sometimes even the phrase, what felt good could be triggering to some of your clients. So just be aware of that when you're talking about taking care of themselves. Yes, we want them to do things that they enjoy that are pleasurable, that feel good. But we may need to find different words for those because they have been conditioned with something exceedingly negative. So just that's my little statement on that. Take it for what you will. And healthy self-talk. Encourage them to talk to themselves like they would talk to their best friend or like they would talk to, you know, when you're dealing with kids, it's hard to say how you would talk to your little brother because a lot of times that's not healthy self-talk. But if you wanted somebody to talk to you, if the roles were reversed and you wanted somebody to tell you something, what would you tell, what would that person be telling you? Encourage taking different perspectives and that they have difficulty with healthy positive self-talk. I would encourage you to review the articles on compassion-focused therapy. Some people have been taught through social learning through experiences that being kind to themselves is a sign of weakness. So they are not willing. It feels very wrong for them to talk nicely to themselves. So compassion-focused therapy. There's a section at the end of the article. I think it was in the British Journal of Psychiatry, but it comes up real easy in Google. And it talks about the reasons people may not be willing to engage in healthy self-talk and things that you can do to help them through that. Interpersonal effectiveness. These are our cheerleading statements. We want to encourage people to tell themselves that they've got this. They're okay. We want to encourage people to tell other people cheerleading statements and to build people up instead of bringing people down. Another one of those famous acronyms, Dear Man, describe objectively, express your feelings. Assert your wants and needs. Reinforce by creating a win-win. Have a mindful focus on the present. Appear confident and negotiate. One of the things we practice a lot is identifying the difference between wants and needs. We also, again, as we talked about earlier, do a lot about emotion identification, even if you can't identify what your heart's saying. Remember, with every emotion, there are physical sensations, thoughts and feelings. So I'll say, okay, what are you thinking? And if that still hits another one, okay, what are you feeling in your body? And that might give us a different clue as to what the person may be emotionally experiencing. And sometimes they're just so alexthymic that they have to start there because they don't know how to put those emotion words with their physical sensations and their thoughts. We talk about win-win situations. I'll ask them in group what situations were frustrating for you or tell me about something that happened at home that you really didn't want to do or that was a challenge. And how could you create a win-win? Maybe they don't want to do chores every day. And so we talk about different ways to make a win-win situation so parents get what they want, child gets something closer to what they want and there's a compromise walking that middle path again. Fast. Treat others fairly. Treat them as you want to be treated. So before you act, think to yourself, if this person did this to me, how would I feel? Apologize when you make a mistake because we all make them, but not for being you. If you have a differing opinion, don't apologize for that. Own your opinion and express it politely, but you don't have to apologize for being you. Stick to your values, what's important to you, and tell the truth. So your mindfulness exercises. Transformation. I love this one. Creative uses for everyday objects, both and. Hangers, chewing gum, duct tape. These are my three go-tos. My daughter has recently taught me a whole bunch of other uses for toothpaste. So you can put toothpaste on the list and encourage people to think about creative ways they can use these things. They can eventually extrapolate that on creative ways they can use their coping tools for dealing with life stresses. But they're getting outside the box. They're thinking, all right, you know, I've got a problem. What is what resources do I have? How can I MacGyver this sense and memories? There are several exercises in this book that talk about different tasting exercises and food oriented exercises. I personally steer away from those. Simply because of the high risk of eating disorders and I really don't want to encourage eating in response to anything but hunger. But that's me. Sense and memories. You can do sense by using little swatches, dryer sheets, cotton balls that have different smells on them. It doesn't have to be an essential oil. Or you can talk about, again, put up the posters and put different feelings on there. Happy memories. What smells do you associate with happy memories? Sad memories. What smells do you associate with those? Blindfolded awareness. If you've got a trauma group or clients in your group who have been traumatized, this may not go over well. So, you know, use your best judgment, obviously. But you can either have a box that they put their hand in and they feel it and try to figure out what's in there. Or you can blindfold them or have them close their eyes and then try to describe either what they're hearing or seeing or smelling or all of the above. Name four and four. Another modification on the senses. Four things you see, four things you smell, four things you hear and four things you feel. Generally, there's not going to be four things they're tasting. Create a special place using that guided imagery. The distress hat is what I talked about earlier. Putting the different emotions in there and sometimes the different physical sensations and having people act them out and try to name what emotion goes with it. Doing emotions collage, if you have access to pictures of stuff, what's associated with happy, what's associated with sad. Nature observation. Take a walk, you know, a five, ten minute walk and figure out what they see, hear, smell, etc. And what they're thinking as they go through. When you saw that, what did you think? You know, when I see squirrels, oh, I love squirrels. They're itty-bitty hands and when they eat, they're so cute because they turn the nuts and their little itty-bitty fingers and usually they look at me and roll their eyes. But okay, because I just love squirrels. Hold ice. One of the interesting things aside from being an intense sensation is when you hold ice, it helps you start understanding how you deal with anger and other intense emotions. When you start feeling pain, what do you want to do? Do you want to yell? Do you want to scream? Do you want to run? Do you want to drop it? Do you want to see how much you can endure? A self-esteem envelope. Pass an envelope around the room. Each person has little strips of paper. They write down on the strip of paper something positive about that person and put it in the envelope. It goes around. So if there's 12 people in group, each person will end up with 11 sheets of paper in their self-esteem envelope because they didn't fill one out on themselves. Writing a movie about my life and you can either talk about it or you can write it. What would be the title? Who would portray you? And who would portray your mother or other main characters in your life and why? And tell me about the main plot. Describe this movie to me. Is it a tragedy? Is it a comedy? What's kind of going on? And it helps them focus on what's going on in their life but not just on the bad stuff. They can focus on all of the supporting characters and figure out some people who actually might be good supports. Imagine that. Feeling charades. We've kind of talked about that. DPT games. DPT charms are just what they sound like. Little charm bracelet charms that suggest different, the different acronyms. The self soothing kit. And I love this one. If you have a cell phone, you can have sort of a digital self soothing kit. So when you start to get under stress, what are some things you can do? I have on mine a heart rate monitor app so I can, you know, check my pulse. I have an app for knock knock jokes. I always love a good knock knock joke. Funny videos from YouTube or Vimeo or anywhere else. Distracting music. My Amazon playlists. Sweet images. I always have images of my animals and my kids. And cathartic or validating images you can have on there. I like grumpy cat myself. You know, I'll just read something he says and I'm just like, yeah, I'm with you there today grumpy. And I feel validated. And you know, that's, that's my sort of self soothing, get through the hard stuff kit. And I share that with my kids, with my clients. They can do that. They can figure out what they want on their cell phone or smartphone. They can also make a tangible self soothing kit. You know, maybe something that has pictures in it and, and, you know, more hard copy stuff. It just depends on who you are. I like the cell phone because most people, their cell phone is sort of an extra appendage now. So they've always got it with them. DBT Jeopardy. Going through just like you would with Jeopardy, different categories and identifying how you would implement DBT skills. DBT infomercials. Talking about selling some of the concepts of dialectical behavior therapy, selling some of the concepts of emotion tolerance. And media DBT finding different show clips, whether it's the Simpsons or a soap opera or, you know, heaven forbid, Dr. Phil. Something that examines or shows you someone getting upset where you can actually talk about how they might have used DBT skills. Or if there's a good example of someone using DBT skills by all means, show that, but I haven't come across that in the media yet. In summary, adolescents are trying to discover their values. What's important to them? They don't know this yet. So they're going to try. They're going to err. They're not necessarily going to be able to answer the what's important to you in the big scheme of things question. They can answer the what's important to you right now. And, you know, maybe this year in school. They're niche. Where do they belong? Who do they get along with? What are their interests and their goals in life? What do they want to do when they theoretically grow up? I personally refuse to grow up. So, you know, I say kind of get older. What are you going to do for a career? And, you know, that's not necessarily set in stone, but what are their interests? So you have a lot more ambiguity when you're dealing with children and adolescents. Adolescents are transitioning from the carefree childhood where they didn't have to make a lot of decisions. And they were buffered from a lot of stuff, hopefully, by their parents to trying to become adults and make new friends and reach out and expand their social circle. And that can be, you know, really threatening or traumatizing. So it's important to understand that this is a really stressful time developmentally and socially for these youth. So things that we as adults may go, oh, if you think that's bad, just wait until you're 25. And you got da, da, da, da, da. You know what? They're not 25. And right now this is taxing their coping skills. So we need to kind of remember what it was like to be there with them. Adolescents almost always have a load of moderate level of stress, making them more vulnerable to emotional reactivity. Again, think back to when you were an adolescent or if you've got adolescents in therapy with you right now or at home. Do they have stuff? I mean, we think about them as going to school and not having a job. So, you know, what could they have to stress about? Oh my gosh, what do they have to stress about a lot? You know, are they wearing the right shoes? Are they going to fit in with this particular group? What happens if they, you know, fart in the middle of class? You know, there's a whole bunch of stuff that they stress about and it seems of imminent importance to them at that particular point in time. And if we tell them, you know, that's, you farted in class, big deal, get over it. Nobody will remember that in a week. That is mortifying to them and they can't conceptualize that people really probably won't remember it. And kids can be mean so most likely actually they may remember that a week or two or three later. So how can we make lemonade out of it? DBT helps adolescents gain control over their emotions, recognizing the emotion and being able to find that stop, you know, the stop before you act. Mindfulness helps them become aware of the what's and why's of their emotion. So, okay, I'm feeling this way. I am completely overwhelmed. I feel like I'm going to burst. What in the heck is going on and why do I feel this way? Once you understand that, you may not be able to change it, but at least it gives a lot of people a greater feeling of control. Most adolescents prefer an indirect approach to learning skills like I talked about a lot in this presentation. Try not to focus on what's salient for you right now, what is just turning your world upside down. In a group setting, that's just not generally feeling safe for a lot of adolescents. In DBT skills groups, we're really focusing on more general stuff, saving the personalized stuff for individual. Through skills groups, adolescents can acquire new skills, relate them to something they know, practice them in a safe environment through scenarios and all that kind of stuff. And come to the awareness for themselves why these skills are helpful. I can tell them until I'm blue in the face that these skills are great. They're helpful. You just have no idea how much it'll make your life easier. And they're just going to look at me going, yeah, you told me that about algebra too. We want them to come to the awareness for themselves of why it works and how it works and why it could be a good thing. All of these activities need to be processed and brought back around to how they can be generalized in the real world. You know, obviously doing the crime scene scenario, it's a fun activity, but what exactly is the take home message? So with adolescents, more so than with adults, you need to connect the dots at the end of group and say, you know, you looked at this crime scene, you came up with an explanation for how this happened. A lot of people had different ideas and different hypotheses about what happened. The same thing can happen at school when something goes wrong. People can make assumptions or they see things a little bit differently. So think about that the next time you're in a social situation and there seems to be a misunderstanding. The dbt and mindfulness activities again are really great. I find that this book, the 101 activities gives you a lot of food for thought. Like I said, there were some of the activities I really didn't like. And there's also a lot of stuff you can Google online. So you don't necessarily have to buy that book. It was just I found it to be helpful for as I learned mindfulness and that kind of stuff for prompting me to think, OK, how can you use this in your group because sometimes my creativity lags a little bit. But that is dbt and mindfulness for adolescents. Are there any questions? If you're ready to leave, you are more than welcome to go take a quiz or whatever and answer to the question. When I work with adults, especially in group, you know, anybody that I'm using the dbt skills groups with, I'm going to assume that they have a certain level of emotional dysregulation. So I'm going to start with non-threatening topics. If I get comfortable enough with the group and if I have a stable enough group where I feel like it's a safe environment, then I might ask them about, you know, give me an example if, for example, the acronym Dear Man, give me an example you could have used Dear Man last week that might have helped you avoid some emotional upset. So I'm not going to get into really touchy subjects in group ever, at least in a dbt situation, in a skills group. But with adults, I will try to ask them to share how they might have, might have been able to use it in the past week and or how they expect they will use it and remember to use it in the upcoming week. And this replay should be available, let's see, today's Tuesday. It should be available on YouTube if you want to review the video for any reason on Thursday. So generally we have about a two-day lag before we get it on YouTube. Everybody have a great rest of your election day and I will see you on Thursday.