Integrative pathways to addiction recovery through DBT & ACT

Use the following worksheets in your workbook for the lesson:

• Pros and cons of emotional mind worksheet page 7

• Understanding wise mind worksheet page 8

• Practicing wise mind handout page 9 & 10

• Understanding WHAT skills handout page 11

• Practicing Observing handout (WHAT skill) page 12-15

• Practice describing handout(WHAT skill) page 16

• Practice participating handout(WHAT skill) page 17

• HOW skills handout page 18

• Practicing non-judgmentally handout (HOW skill) page 19

• Practicing One- Mindfully handout (HOW skill) page 20

• Practicing effectively (HOW skill) page 21

In the lesson on core mindfulness skills in Dialectical Behaviour Therapy (DBT), participants will learn essential techniques to enhance their awareness and presence in the moment. The lesson will cover the following key areas:

1. Mindfulness Fundamentals: Understanding the core principles of mindfulness, including non-judgment, acceptance, and being present.

2. Observing and Describing: Developing the ability to observe thoughts and feelings without becoming attached to them, as well as learning to articulate these observations accurately.

3. Participating Fully: Engaging fully in activities and interactions, fostering a sense of immersion in the experience without distraction.

4. Mindfulness Exercises: Practising specific exercises that promote mindfulness, such as breathing techniques, body scans, and guided meditations, to cultivate a deeper connection with oneself.

5. Handling Distress: Learning to utilise mindfulness as a tool for managing emotional distress and enhancing emotional regulation.

By the end of the lesson, participants will have a solid foundation in mindfulness skills, enabling them to apply these techniques in their daily lives and improve their overall emotional well-being.

In the module of emotional regulation you will learn essential skills for identifying, understanding, and managing emotions effectively. The key components include:

1. Understanding Emotions: Gain insight into the nature of emotions, their functions, and how they influence behaviour and thoughts.

2. Identifying Emotions: Develop the ability to recognise your own emotional responses and the triggers that may lead to heightened emotional states.

3. Regulating Emotions: Learn strategies to modulate emotional responses, including techniques for decreasing the intensity of negative emotions and increasing positive emotional experiences.

4. Skills Training: Explore specific DBT skills, such as the 'ABC PLEASE' skills, which help in building emotional resilience and enhancing overall well-being.

5. Crisis Management: Understand how to implement crisis survival strategies when faced with overwhelming emotions, ensuring you can remain grounded and reactive in challenging situations.

Overall, this lesson aims to equip you with practical tools and insights to foster healthier emotional experiences and improve interpersonal relationships, thus enhancing emotional intelligence and stability.

Feelings wheel handout: page 23

Emotion Awareness worksheet: page 24

In this lesson on identifying emotions in Dialectical Behaviour Therapy (DBT), you will learn

Identifying Personal Emotions: Techniques for recognising and labelling your own emotions accurately. This includes differentiating between primary and secondary emotions and understanding triggers.

The Emotion Wheel: Utilising tools like the emotion wheel to expand your emotional vocabulary, helping you articulate your feelings more precisely.

Emotional Dysregulation: Exploring the concept of emotional dysregulation, how it manifests, and its implications for mental health.

Worksheets and handouts

• Check the facts worksheet: Pages 25-29

• ‘What next’ worksheet: Page 30

• Recording thoughts worksheet: Page 31-32

• Opposite action worksheet: Page 34-35

• Problem Solving worksheet: Page 36-37

• Pleasant events worksheet: Page 38

  
  

  The lesson provides various strategies to change emotional responses. Techniques may include engaging in opposite action (behaving in ways that are contrary to the emotional urge) or modifying the environment to reduce triggers.

Worksheets and handouts

• Clarifying priorities: page 40-41

• Interpersonal effectiveness scripts: page 42

  
  

  Interpersonal effectiveness skills are vital for you in Dialectical Behaviour Therapy (DBT). These skills equip you with the necessary tools to communicate your needs effectively, set clear boundaries, and nurture healthy relationships. By developing these skills, you can enhance your social interactions, reduce feelings of alienation, and cultivate emotional resilience.

Assertiveness stands as a cornerstone of interpersonal effectiveness. It empowers you to express your thoughts and feelings authentically while maintaining respect for both yourself and others. This balance helps mitigate tendencies towards passivity or aggression in your interactions.

Moreover, mastering negotiation and compromise is essential in finding solutions that work for all parties involved during conflicts. These skills not only preserve relationships but also foster a sense of personal control and satisfaction in your social exchanges.

In sum, investing in your interpersonal effectiveness skills allows you to build meaningful relationships and improves your overall mental health. This journey leads you towards a more balanced and fulfilling life.

Worksheets and handouts

• Validation how to guide: page 45

  
  

  In the lesson "Walking the Middle Path" you will learn the concept of balancing opposites to achieve emotional stability and a more fulfilling life. This approach encourages the recognition that situations and feelings are often not purely one thing or another, but can exist on a spectrum.

Key topics will include understanding the extremes of emotional responses and the importance of finding a middle ground. You will explore strategies to navigate conflicts and improve interpersonal relationships by integrating differing perspectives. The lesson emphasises the significance of validation—acknowledging your own and others' experiences—while also addressing the need to communicate effectively without escalating tensions.

By practising the skills learned in this lesson, you will be equipped to handle challenges with greater resilience, promote emotional regulation, and foster healthier relationships, ultimately enabling you to lead a more balanced and harmonious life.

Worksheets and handouts

• Ending relationships: page 43-44

• Refusing drink and drugs; page 46

• Setting Boundaries: page 47-48

• Correcting problems in relationships: page 49-51

  
  

  In the managing people and peer pressure lesson within the interpersonal effectiveness module, you will explore several key areas:

1. Understanding Peer Pressure: Gain insights into the dynamics of peer pressure, including its sources and the psychological mechanisms behind it. You will learn to identify both positive and negative influences from peers and how these impact decision-making.

2. Strategies for Resisting Negative Peer Pressure: Discover effective techniques to stand firm against negative peer pressure. This includes developing assertiveness skills, setting personal boundaries, and practising refusal skills in various social contexts.

3. Building Healthy Relationships: Learn the principles of fostering positive interactions with peers and colleagues. Emphasis will be placed on effective communication, empathy, and conflict resolution to create supportive environments.

4. Validation: Understand how to validate and motivate others while maintaining integrity and promoting an environment that encourages positive choices.

5. Self-awareness and Emotional Intelligence: Reflect on your own values and behaviours, and understand how increased self-awareness and emotional intelligence can enhance your interpersonal effectiveness.

By the end of the lesson, you will be equipped with the tools and strategies necessary to navigate peer pressure and manage interpersonal relationships effectively in both personal and professional settings.

Distress tolerance skills are pivotal for you when facing emotional turmoil and crisis situations. These skills enable you to endure and manage distressing feelings without resorting to harmful behaviors or impulsive decisions. By cultivating resilience and enhancing your emotional regulation, distress tolerance skills encourage a mindful approach to adversity, allowing you to cope more effectively with immediate stressors. This not only fosters a sense of agency and control in challenging circumstances but also promotes long-term mental well-being, empowering you to navigate life's difficulties with a more balanced and constructive mindset.

Radical acceptance: page 53-54

Radical acceptance is a fundamental component of Dialectical Behaviour Therapy (DBT) for you, as it emphasizes the importance of acknowledging and accepting the reality of your situations without judgment. This practice allows you to confront distressing emotions and experiences without resorting to maladaptive coping mechanisms, such as avoidance or self-harm. By embracing radical acceptance, you can reduce emotional suffering, cultivate resilience, and foster a more profound sense of self-awareness. This acceptance does not imply approval of your circumstances; rather, it facilitates a healthier relationship with pain and adversity, enabling you to focus on making constructive changes in your life. Ultimately, radical acceptance serves as a powerful catalyst for your personal growth and emotional regulation within the DBT framework.

In these informative videos, we will thoroughly examine specific distress tolerance skills that were initially developed by Dr. Marsha Linehan, with the primary aim of providing assistance to those grappling with addiction-related challenges.

Worksheets and handouts

Recording thoughts: page 31-32

Mindfulness of Current Thoughts is a fundamental skill within Dialectical Behaviour Therapy (DBT) that encourages you to observe and acknowledge your thoughts without judgement. This practice involves being present and recognizing your thoughts as transient mental events rather than fixed truths. By training yourself to notice thoughts as they arise, you can develop greater awareness of your inner experiences and reduce the tendency to react impulsively or distressingly to them.

This skill promotes a non-reactive stance, allowing you to create space between yourself and your thoughts. In doing so, it fosters emotional regulation, enhances cognitive clarity, and contributes to your overall mental well-being. Practicing mindfulness of current thoughts helps you understand your cognitive patterns and challenges distorted thinking, ultimately leading to more effective coping strategies and improved emotional control.

Understanding the three stages of relapse is crucial for you as someone recovering from addiction, or someone who is trying to steer clear of unhealthy habits, as it provides a framework for recognizing and addressing potential setbacks. The stages—emotional, mental, and physical—highlight the progressive nature of relapse, allowing you and your support network to intervene at various points.

By comprehending these stages, you can develop proactive strategies to maintain your sobriety, foster a deeper self-awareness, and create a robust support system that addresses emotional and mental struggles before they culminate in a physical relapse. This knowledge is instrumental in fostering your lasting recovery.

In this lesson on towards and away behaviours, you will learn to identify the fundamental distinctions between actions that draw you closer to your goals and those that lead you away from them. As well as the fears or obstacles that contribute to away behaviours, including avoidance and procrastination. The lesson will also provide practical strategies for enhancing towards behaviours while minimising away behaviours, empowering you to make more intentional choices in pursuit of your objectives.

In this lesson, you will explore the concepts of learned behaviour, habits, and the phenomenon of being in autopilot. You will learn how behaviours are acquired through experience and repetition, shaping our reactions and decision-making processes. The lesson will delve into how habits are formed, categorising them into cues, routines, and rewards, which create a loop that can reinforce actions over time. Additionally, the impact of autopilot on daily life will be examined, highlighting how automatic behaviours can provide efficiency but also lead to a lack of mindfulness. By the end of the lesson, you will have a clearer understanding of these psychological principles and strategies to cultivate more conscious and intentional behaviours in your daily routines.

In the lesson on unhooking thoughts, you will learn techniques to detach from unhelpful or distressing thoughts that can lead to negative emotional states and behaviour patterns. The lesson will cover the concept of cognitive fusion versus cognitive defusion, illustrating how the former can trap individuals in their thoughts, while the latter allows for greater psychological flexibility. Additionally, practical exercises will be introduced to help recognise and challenge intrusive thoughts, fostering a sense of distance from them. By the end of the lesson, you will have acquired strategies to identify, manage, and release thoughts, enhancing overall mental well-being and promoting a more balanced perspective.

In the lesson on urge surfing, you will learn how to recognise and manage cravings in a constructive manner. The concept of urge surfing involves observing urges as they arise and understanding their transient nature, rather than yielding to them. You will explore techniques for building awareness around your emotions and thoughts associated with cravings, allowing you to create space between the urge and your response to it. The lesson will also cover strategies for increasing mindfulness and developing coping mechanisms that can effectively help you ride out cravings without resorting to addictive behaviours. Overall, you will gain valuable tools for maintaining sobriety and enhancing your resilience in the face of temptation.

Worksheets & Handouts

Triggers worksheet: Page 61

In the lesson on triggers, you will learn about the psychological and emotional stimuli that elicit specific responses in individuals, particularly in relation to addiction and recovery. Key topics will include:

1. Definition of Triggers: Understanding what constitutes a trigger and the different types, including emotional, environmental, and social triggers.

2. Identifying Personal Triggers: Techniques for recognising your own triggers, which may lead to cravings or relapse.

3. Understanding the Brain's Response: How triggers affect the brain and can create habitual responses, making recovery challenging.

4. Coping Strategies: Strategies to manage and cope with triggers effectively, including mindfulness practices, avoidance techniques, and support systems.

5. Creating a Trigger Action Plan: How to formulate a personalised action plan that includes recognising triggers and employing coping strategies proactively.

By the end of the lesson, you will have a comprehensive understanding of triggers and practical tools to mitigate their impact on your recovery journey.

In this lesson on mindset reframes, you will learn the fundamental concepts behind reframing your perspective on challenges and setbacks. The session will guide you through the identification of negative thought patterns and how to transform them into positive, empowering narratives.

Worksheets & Handouts

Checklist: page 56

Worksheet: page 57

In this lesson on unhealthy versus healthy coping mechanisms, you will learn to distinguish between different strategies used to manage stress and emotional challenges.

Firstly, the lesson will cover various unhealthy coping mechanisms, such as substance abuse, avoidance, and aggressive behaviours. You will explore the short-term relief they may provide, contrasted with their long-term consequences, including impaired relationships and negative impact on mental health.

Next, the focus will shift to healthy coping strategies, which include problem-solving, mindfulness, physical activity, and seeking social support. You will learn how these approaches contribute to overall well-being and emotional resilience, fostering a more positive response to stressors.

The lesson will also provide practical tips for identifying personal coping styles, encouraging self-reflection to help you understand your responses to stress. Additionally, you will engage in exercises designed to reinforce healthy coping techniques, equipping you with skills to replace harmful habits with constructive behaviours. Ultimately, you will leave with a clearer understanding of how to cultivate a healthier approach to coping with life's challenges.

In the lesson on practising gratitude, you will learn the importance of cultivating a grateful mindset and how it can significantly enhance your overall well-being. The session will cover various techniques for expressing gratitude, such as keeping a gratitude journal, engaging in mindful reflection, and sharing appreciation with others. You will explore the psychological benefits associated with gratitude, including its positive impact on mental health, relationships, and stress reduction. Additionally, the lesson will provide practical exercises to help integrate gratitude into your daily life, fostering resilience and promoting a more positive outlook. By the end of the session, you will have a comprehensive understanding of gratitude’s role in personal development and strategies to incorporate it effectively into your routine.

Acceptance Commitment Therapy (ACT) is a cognitive-behavioral intervention that aims to foster your psychological flexibility by encouraging you to accept your thoughts and feelings rather than fighting or feeling guilty about them. This therapy promotes mindfulness and self-acceptance while helping you commit to actions that align with your values. Through the use of experiential exercises, you will learn to observe your thoughts without judgment, enabling you to create a richer engagement with life despite the presence of difficult emotions. ACT emphasizes the importance of living fully in the present and taking actionable steps toward meaningful goals, thereby enhancing your overall well-being.

In the lesson on being present in ACT (Acceptance and Commitment Therapy), you will learn the importance of mindfulness and how it contributes to psychological flexibility. The session will cover techniques for anchoring your awareness in the current moment, including breathing exercises and sensory awareness practices. You will explore the concept of observing thoughts and feelings without judgement, which helps to reduce their impact on your behaviour. Additionally, the lesson will introduce the role of values in guiding your actions and how being present can enhance your commitment to those values. Overall, you will gain practical skills to cultivate a mindful awareness that can support your emotional resilience and overall well-being.

Worksheets & Handouts

Page 70 & 71

In the lesson on cognitive defusion in Acceptance and Commitment Therapy (ACT), you will learn about the concept of cognitive defusion and its role in enhancing psychological flexibility. The lesson will explain how cognitive defusion techniques help individuals distance themselves from unhelpful thoughts and beliefs, allowing for a more favourable engagement with one’s experiences. You will explore various strategies, such as visualising thoughts as external objects or using metaphors, to reduce the impact of negative thinking patterns. Additionally, the lesson will highlight the benefits of cultivating a mindful awareness of thoughts without automatically reacting to them, fostering greater emotional resilience and improved decision-making. Finally, practical exercises will be provided to facilitate the application of cognitive defusion in real-life situations, promoting a more meaningful and value-driven life.

Worksheets and handouts

Radical acceptance: page 53-54

This is a recap of what you learned earlier in radical acceptance.

Worksheets & Handouts

Recording thoughts worksheet: page 72 & 73

In the lesson titled "Observing Self in Act," you will learn the importance of self-awareness and mindfulness. The lesson will cover techniques for observing your thoughts, feelings, and behaviours in real-time, allowing you to recognise patterns and make informed choices. Key concepts will include the role of self-reflection in your growth, methods for cultivating a non-judgmental observation stance, and the impact of self-observation on your interpersonal relationships and decision-making. By the end of the lesson, you will have practical tools to enhance your self-awareness, leading to improved emotional intelligence and more effective interactions with others.

Worksheets & Handouts

‘Who am i ?’ Worksheet: page 67

Values self exploration worksheet: page 68 & 69

Figuring our your values worksheet: Page 76 - 79

In the lesson on values in Acceptance and Commitment Therapy (ACT), you will learn how to identify and clarify your personal values. This involves understanding the distinction between values and goals, recognising that values are guiding principles that inform behaviour rather than specific achievements. You will explore techniques for integrating these values into daily life, enhancing psychological flexibility, and fostering commitment to actions aligned with what truly matters to you. The lesson will also cover the significance of values in overcoming obstacles, as well as strategies for navigating situations where values may be challenged. By the end of the lesson, you will have practical tools to live a value-driven life, leading to greater fulfilment and purpose.

Worksheets & Handouts

Commiting action Worksheet: page 74

Aligning Goals worksheet: page 80

Fear of action worksheet: page 81 & 82

Goal action: page 83

In the lesson on committed action in Acceptance and Commitment Therapy (ACT), participants will learn the significance of taking actionable steps towards personal values while embracing the challenges that come with them. The lesson emphasises the importance of setting specific, tangible goals that align with one’s values and developing a flexible approach to overcome any barriers encountered along the way. Participants will also explore techniques for maintaining motivation and persistence, even in the face of setbacks. Additionally, individuals will understand how committed action fosters psychological resilience and contributes to overall well-being, enabling them to lead a more meaningful and purposeful life.