1. Counseling Skills Workshop Mindfulness and Effective Coping Jane B. Finch, LCSW Changes By Choice Durham, NC

2. Brief Treatment? Bob Newhart & Mo Collins Skills Training Manual for Borderline Personality Disorder. Marsha Linehan, 1993. SMART Recovery Handbook, 2 nd Edition. Henry Steinberger, PhD, Editor, 2004. www.smartrecovery.org

3. Major Causes of Relapse Escape from negative emotional states (35%) Social pressure (20%) Direct or indirect Interpersonal conflict (16%) Desire for positive emotional states (12%) Escape from negative physical states (12%) Testing personal control (5%)

4. Step 1: Agency

5. Where am I right now? (Mindfulness) What are my options? 1. Change the situation (Interpersonal effectiveness) 2. Change my reaction to the situation (Emotion regulation) 3. Accept the situation and my reaction as they are (Distress Tolerance) Or …. 4. Stay miserable Skills for Coping: “DBT Lite”

6. Mindfulness Present-moment awareness: five senses What: Observe, Describe, Participate How: Non-judgmentally, One-mindfully, Effectively Simple watching-the-breath exercise

7. Interpersonal Effectiveness Challenge myths (“I must be inadequate if I can’t fix this myself” “I should be willing to sacrifice my own needs for others”) Describe, Express, Assert, Reinforce Practice saying no… especially to drink/drug offers

8. Emotion Regulation Most people think the sequence goes: Event  Emotion  Action Instead, we teach: Event  Self-Talk  Body Response  Emotion  Action And encourage patients to have sober FUN regularly to offset events they can’t control.

9. Distress Tolerance ….how to get through difficult situations when you can’t solve the problem (right away, or at all) without making things worse (using). Distractions Prayer, meaning Self-soothing (Radical) Acceptance

10. Change takes time…. And setbacks occur. Be patient, flexible, and accepting. Refer to a specialist for deeper trauma. And remember what YOU can and can’t change!