This coping skill involves breathing in for 4 counts, holding for 4, breathing out for 4, and holding for 4. Name it.
Box breathing (square breathing)
This common therapy approach focuses on the connection between thoughts, feelings, and behaviors.
CBT (Cognitive Behavioral Therapy)
"I failed this one assignment, so I'm a complete failure."
All-or-nothing thinking (black-and-white thinking); labeling
"You never listen to me!"
Sample answer: "I feel unheard when I'm interrupted. I'd like to finish my thought."
OCD is mostly about being clean and organized.
FALSE. OCD involves intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) done to reduce distress. Themes vary widely – contamination is only one of many
Name the grounding technique where you identify 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste.
The 5-4-3-2-1 technique
What does it mean to "validate" someone's emotions? Does validating mean agreeing?
Validation means acknowledging that someone's feelings are real and understandable given their experience. No – you can validate an emotion without agreeing with the thought or behavior
"My friend didn't text me back. She must be mad at me."
Mind reading (jumping to conclusions)
"You make me so angry when you cancel plans."
Sample answer: "I feel frustrated and disappointed when plans get canceled last minute, because I look forward to our time together."
You can have depression even if there's "nothing wrong" in your life.
TRUE. Depression is a medical condition influenced by biology, brain chemistry, genetics, and life experiences. It does not require an obvious external cause
In DBT, this acronym stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. What is it, and when would you use it?
TIPP – used in moments of crisis or intense emotional distress to quickly lower emotional intensity
Define "trigger" in a treatment context, and name one way a person can respond to a trigger other than reacting automatically.
A trigger is a person, place, situation, or internal experience that prompts a strong emotional response or urge. Alternative responses: pause and notice, use a coping skill, reach out for support, remove yourself from the situation
"I got positive feedback at work, but they were probably just being nice."
Discounting the positive
"Nothing ever works out for me."
Sample answer: "Some things haven't gone the way I hoped, and some things have. Right now I'm dealing with a hard situation, and I can take it one step at a time."
A panic attack can feel like a heart attack, but it is not physically dangerous.
TRUE. Panic attacks can cause chest pain, racing heart, shortness of breath, and dizziness, but the panic attack itself is not medically dangerous, and symptoms typically peak within about 10 minutes
True coping or avoidance? Scrolling on your phone for 3 hours to not think about a stressful conversation you need to have. Explain your answer.
Avoidance – it delays the stressor without addressing it, and distress usually returns or grows. (Bonus discussion: distraction can be healthy short-term coping if it's intentional and time-limited)
What is the "window of tolerance"? What happens when someone is outside of it?
The zone of arousal where a person can function and process effectively. Outside of it, they may become hyperaroused (anxious, panicked, angry) or hypoaroused (numb, shut down, dissociated)
"If I speak up in group, I'll say something stupid, everyone will judge me, and I'll never be able to come back."
Catastrophizing; fortune telling
"You don't care about my recovery at all."
Sample answer: "I feel unsupported when my appointments aren't asked about. It would mean a lot to me if you checked in about how treatment is going."
People with bipolar disorder are just "moody" and switch emotions minute to minute.
FALSE. Bipolar disorder involves distinct episodes of depression and mania or hypomania that typically last days to weeks, not moment-to-moment mood swings
Describe the difference between emotion-focused coping and problem-focused coping, and give one example of each.
Problem-focused coping addresses the stressor itself (e.g., making a plan, asking for help, breaking a task into steps). Emotion-focused coping manages the emotional response when the stressor can't be changed (e.g., self-soothing, journaling, radical acceptance)
Explain the difference between a lapse and a relapse, and why the distinction matters in recovery.
A lapse is a brief slip or return of symptoms/behaviors; a relapse is a fuller return to old patterns. The distinction matters because a lapse doesn't erase progress – catastrophizing a lapse ("I've ruined everything") can turn it into a relapse
"I should be over this by now. I shouldn't still be struggling." Name the distortion AND explain why this type of thinking is harmful.
"Should" statements. They create shame and guilt by holding us to rigid, often unrealistic standards, and they judge our experience instead of accepting where we actually are
Rewrite this into a full DEAR MAN-style request: "You always dump extra work on me and I'm sick of it."
Sample answer: "When I'm assigned tasks at the end of the day (Describe), I feel overwhelmed and stressed (Express). I'm asking that we talk about deadlines before new tasks are added to my plate (Assert). If we can do that, I'll be able to do better work and be more reliable (Reinforce)."
Dissociation is rare and only happens to people with severe trauma.
FALSE. Dissociation exists on a spectrum – mild forms like zoning out or highway hypnosis are common and happen to everyone. More intense dissociation can be a response to stress or trauma, but it is a protective mechanism, not a sign of being "broken"