• Crisis lines:

  • For a life threatening emergency, call 911

  • Call or text 988 for the national suicide and crisis lifeline

  • Call 711 for the 24/7 Washington state crisis line relay for King, Pierce, Clark, Skamania, Klickitat, Grant, Okanogan, Chelan, and Douglas counties; this crisis line can help you determine appropriate emergency mental health services

• Crisis lines for specific populations and specific challenges:

  • For teens: Call Washington Teen Link at 866-833-6546

    • To speak with a peer (another teen), call the line above from 6-10pm or chat and text from 6-9:30pm

    • To speak with an adult, call the line above from 3-6pm

    • To speak with a substance use clinician, call the line above from 3-6pm and press "2"

  • LGBTQ-specific support: Call, text or chat The Trevor Project for free, 24/7

    • Text "START" to 678-678, or call 1-866-488-7368. You can also chat with them online via the link above

  • Trans-specific support: Call the Trans Lifeline 24/7 at https://translifeline.org/ 

    • Note: Trans Lifeline is not taking calls from 12/18/23-12/31/23 and will resume 24/7 calls on 1/1/24

  • For substance use, gambling, and mental health concerns: Call Washington Recovery Hotline 24/7 at 866-789-1511

  • Additional details including other regionally specific crisis resources 

• DBT Skills Training: Handouts and Worksheets- #1 book I'd recommend getting. There are open PDFs of this online (just Google it!) though I recommend getting a hard copy so you can fill it out yourself

  • Note: Please make sure you get the skills book, not the training manual, which is geared toward clinicians (you can get that too, if you like, but it's supplemental/far beyond what most clients want)

• The Skillful Podcast- solid podcast covering DBT skills application, great for those who prefer to consume information in this format

• DBT Skills List- a useful reference, and worth having easily accessible or saved to your phone photos or notes. Google "DBT Skills List printable" for a variety of additional options

A few words of caution:

• 1. There's no replacement for learning the skills in their entirety, then picking and choosing what elements work best for you

  2. There's a reason therapies like DBT have a full complement of skills and don't reduce it down to a top 10- this will almost definitely not be sufficient to make change in your life. Instead, consider this a "taster" or a place to start from

  3. Self-teaching skills is typically not sufficient to get the outcomes people are looking for, particularly without consistent feedback from a therapist. Applying skills in real life leads to confusion for even the savviest, smartest people!

All this said, I'm a pragmatist- I get that not everyone is able or willing to dedicate the time to learning all of the skills

Please note I cannot directly endorse or vouch for the quality or competence of any of these organizations.

• Use your health insurance out of network benefits to reimburse a portion of private therapy costs. Most companies reimburse 40-80% of out of network therapy costs, with some reimbursing the full session fee.

• Try group therapy practices who have interns. Interns are graduate students learning to be therapists who practice under the supervision of seasoned practitioners; therapy with interns is typically offered at a steeply discounted rate. Examples of WA practices with graduate student interns:

  • River Bank Therapy

  • Self Space Seattle

  • Alliant Therapy Group

  • Bastyr Counseling Services

  • CityU Counseling Center

  • Antioch University Community Counseling and Psychology Clinic

  • MEND Seattle

• Try a nonprofit, low-cost directory service such as Open Path Collective

• Try community mental health centers, particularly if you are insured through the state (e.g. Medicare, Medicaid). Most community mental health programs offer many services beyond therapy, too, including wraparound care, psychiatric medication management, case management, substance use treatment, family therapy, and more. 

  • Asian Counseling and Referral Services - focuses on AAPI community

  • Compass Health

  • Consejo Counseling and Referral Services - focuses on Latinx community

  • Center for Human Services

  • International Community Health Services

  • Kitsap Mental Health Resources

  • Mental Health and Addiction Services at Harborview 

  • Navos

  • Sound Health

  • Therapeutic Health Services

  • UV Cares

  • Youth Eastside Services - serves people from birth to age 22

  • Need more options? Try calling a regional or state crisis line to be connected to an organization that suits your needs

• If you have state insurance/Apple Health, consider contacting your health plan provider for an in-network referral 

• Ever wonder why therapy is so expensive? What about why it's so hard to find a therapist you like? Here are a few resources which I feel accurately explain the problems which keep therapy inequitable and difficult to access

  • South Seattle Emerald: "Ask a Therapist: Why is Therapy So Expensive?"

  • Harvard Medical School Primary Care Review: "Here's Why Mental Healthcare is So Unaffordable & How COVID-19 Might Help Change This"

  • Mind Wellness Center: "Why is Therapy So Expensive?"

  • Center for American Progress: "The Behavioral Healthcare Affordability Problem"

• Values card sort - I highly recommend doing a values sort every couple of years. Valuable questions you can ask yourself to further the process include:

  • • Is the way I currently live my life in line with my values?

    • What could I change to live more congruently with my values?

    • What do my values say about me?

• When is the last time you tried journalling? Journalling (by most any method, including the notes app on your phone, audio/voice notes, or typing and handwriting) helps us achieve many things:

  • • Externalizing thoughts

    • Increasing awareness of self through observing thoughts, emotions, and patterns of behavior

    • Opportunity to overtly practice changing how we speak to ourselves

    • Symptom identification and tracking

    • If you're research-minded, check out this meta-analysis of randomized controlled trials on the effectiveness of journalling on mental illness

• Basic self-awareness requires knowledge of our present emotional state. Psychological research consistently shows us that those people who identify and label their emotions are better emotion regulators. Try practicing emotion identification and labelling. Many people find the following tools to be helpful:

  • Emotion wheel - pick one you like the best! I encourage clients to put this somewhere they can reference it easily (e.g. taped to the bathroom mirror, saved to your "liked" photos on your phone, etc)

  • Mood tracking - don't knock it until you've tried it!

    • Apps for mood tracking and journalling:

      • Moodnotes

      • Daylio

      • Finch

      • Daily Bean

    • Pen and paper methods:

      • Mood journalling (including bullet journalling)

      • Google "mood tracker printable" for online options- choose whatever suits you best

      • DBT diary card

• Mindfulness - if we're not fully experiencing the present moment, we're probably not experiencing ourselves fully, either. Mindfulness strategies of all kinds can help us feel more connected to and knowledgeable about who we are. See Mindfulness section for more details and ideas.

• Health at Every Size (HAES)

  • Additional HAES-aligned resources

  • HAES information for kids (5-12th grade) via National Geographic

• Debunking fatphobia and bogus science:

  • Maintenance Phase, an evidence-based podcast that's fun and scientific

  • A seminal literature review explaining the move away from weight-centered health, and the science that supports HAES

  • BMI (Body Mass Index) - why it sucks and isn't an accurate measure of a person's health

    • From FiveThirtyEight

    • From the Harvard T.H. Chan School of Public Health

    • From the CDC (targeted at practitioners, but useful for all)

  • The health consequences of weight/size discrimination- I highly recommend this article for an in-depth summary of major fatphobia issues in medicine, via the University of Illinois - Chicago School of Public Health

• How to find providers who don't suck at talking about size, shape, and the realities of living in a human body:

  • Rule-out and rule-in providers by looking for important keywords in their bios and descriptions (e.g. rule-in HAES, all foods fit, body neutrality; rule-out weight loss, dieting, broad recommendations for restriction or exclusion of foods)

• Managing weight and size conversations at the doctor's office

• Book recommendations:

  • Fearing the Black Body: The Racial Origins of Fat Phobia by Sabrina Strings

  • The Body is Not An Apology by Sonia Renee Taylor

  • Sick Enough: A Guide to the Medical Complications of Eating Disorders by Jennifer L. Gaudiani

Resources for the following:

• Polyamory

• Kink

• LGBTQIA+

• Parenting teens

• Adulting, everyday tasks, and executive function