CBT: Train Your Brain
What is the CBT triangle?
The CBT Triangle explains that our thoughts, feelings, and behaviors all influence one another.
Teach the group one grounding skill that could help someone who is overwhelmed.
What are the goals of mindfulness?
The goals of mindfulness are to become more aware of the present moment, notice thoughts and emotions without judgment, reduce automatic reactions, and respond with greater intention and acceptance.
What is the Window of Tolerance?
The Window of Tolerance is the zone where we are emotionally regulated and able to think clearly, solve problems, make decisions, and respond effectively to stress. When we are within our window, we can manage our emotions and use healthy coping skills.
Why is nutrition beneficial for recovery?
Good nutrition provides the brain and body with the nutrients needed to heal after substance use. Eating balanced meals can improve energy, mood, concentration, sleep, and emotional regulation while helping reduce cravings caused by hunger or unstable blood sugar.
What are cognitive distortions? Give an example.
Answer: Cognitive distortions are unhelpful or inaccurate thinking patterns that can negatively affect our emotions and behaviors. Examples include:
Walk us through the STOP skill. Give an example of when you might use STOP.
What does it mean to have a nonjudgmental attitude in mindfulness?
A nonjudgmental attitude means noticing your thoughts, emotions, body sensations, or experiences without labeling them as good, bad, right, or wrong. Instead of criticizing yourself or trying to push experiences away, you observe them with curiosity and acceptance.
What happens to your brain and body during the fight, flight, or freeze response?
When the brain perceives a threat, it activates the body's stress response to help you survive. During fight or flight, the sympathetic nervous system increases heart rate, breathing, blood pressure, and muscle tension while releasing stress hormones like adrenaline and cortisol to prepare the body for action. During freeze, the body may become still, numb, disconnected, or unable to act, which is another automatic survival response when fighting or escaping doesn't seem possible. These responses are normal and adaptive during real danger but can become overactive after chronic stress or trauma.
Why is sleep important for mental health and recovery?
Sleep helps the brain recover, improves mood, strengthens memory and concentration, reduces stress, and improves emotional regulation. Poor sleep can increase cravings, irritability, anxiety, and the risk of relapse.
What is cognitive restructuring?
Cognitive restructuring is the process of identifying an unhelpful thought, examining the evidence for and against it, and replacing it with a more balanced, realistic thought.
A friend says something that makes you angry. Your first instinct is to yell at them. How would Wise Mind respond?
What does it mean to Observe, Describe, and Participate?
What is neuroplasticity, and why is it important in recovery?
Neuroplasticity is the brain's ability to change, adapt, and form new neural connections throughout life. Recovery is possible because repeated healthy behaviors strengthen new brain pathways while old unhealthy pathways become weaker over time.
Why is exercise beneficial for recovery?
Exercise can improve mood, reduce stress, increase natural dopamine and endorphins, improve sleep, reduce anxiety, and support overall brain and body health.
What are core beliefs? Give an example.
Core beliefs are deep, underlying beliefs we hold about ourselves, other people, or the world that influence how we interpret situations. Examples include "I'm not good enough," "People can't be trusted," or "I am capable of overcoming challenges."
Explain Opposite Action and give an example.
Depression tells you to stay in bed.
Opposite Action might be getting dressed, taking a walk, or attending group.
Choose one activity (walking, showering, eating, cooking, cleaning, or another daily task) and explain how you could do it mindfully.
Possible Answer:
If walking:
If showering:
Why are coping skills harder to use when you're overwhelmed?
When we're overwhelmed, our brain shifts into survival mode. The parts of the brain responsible for thinking clearly, problem-solving, and making thoughtful decisions (the prefrontal cortex) become less active, while the brain's survival systems become more active. As a result, it's harder to remember and use healthy coping skills, and we're more likely to react automatically.
This is why it's important to:
Name three domains of wellness. (There are eight total.)
Emotional, Physical, Social, Occupational, Financial, Intellectual, Spiritual, Environmental.
A client thinks, "I relapsed, so I'm a complete failure and I'll never recover." Identify one cognitive distortion and give one more balanced replacement thought.
The distortion could be all-or-nothing thinking, overgeneralization, or labeling. A balanced replacement thought might be, "I made a mistake, but one relapse doesn't erase the progress I've made. I can learn from this and get back on track."
You're overwhelmed with sadness after receiving bad news and feel like your emotions are taking over. Build a DBT plan using at least three skills to help you get through the next 30 minutes.
STOP, TIPP, Wise Mind, Opposite action, Self-soothe, distract with ACCEPTS, Radical Acceptance, Check the facts.
You're experiencing a strong craving to use substances. How could mindfulness help you respond instead of react?
Possible answers:
A client says:
"Ever since I stopped using, I don't enjoy anything anymore. Nothing is fun."
Explain what's happening in their brain and why this doesn't mean recovery isn't working.
During addiction, substances produce large surges of dopamine, causing the brain to adapt by becoming less sensitive to natural rewards. After stopping substance use, everyday activities like eating, spending time with family, hobbies, or exercising may not produce enough dopamine to feel enjoyable. This can lead to anhedonia, or a reduced ability to experience pleasure.
This does not mean recovery isn't working. It is often a normal part of the brain healing. Through neuroplasticity, the brain gradually rebuilds healthy reward pathways. As a person continues practicing healthy habits, connecting with others, exercising, getting adequate sleep, and staying sober, the brain slowly becomes more responsive to natural rewards again.
A client reports they have been staying up until 2:00 a.m., eating mostly junk food, isolating in their room, and no longer exercising. They say their mood is getting worse and they're having more cravings.
Using the dimensions of wellness, identify at least three areas they could improve and explain how those changes might support recovery.