Client Resources
Here are suggestions and links to resources you might find helpful, and which I regularly refer to in therapy:
This part of my site acts as a living document and therefore errors will happen! Please feel free to let me know if there are dead/incorrect links, typos, etc, and I will update it.
Crisis tools
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
Learning DBT skills
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
Desert Island skills
If I had to pick the 10 skills I reference the most, they would be:
Mindfulness: basic definition and principles (HOW and WHAT skills)
Mindfulness of current thoughts and emotions (building meta-awareness of self)
Radical acceptance (including dialectics)- beware of common radical acceptance mistakes:
Radical acceptance does not mean you have to approve or be ok with facts about reality- just that you need to fully acknowledge those facts for what they are
You do not have to radically accept something that isn't a fact or a reasonable limitation on the future
Having radically accepted something does not mean you feel "at peace" with it (not at all!)
TIP - for crisis, panic, and high distress
54321 - for grounding, mindfulness, dissociation, and/or crisis
PLEASE - to decrease vulnerability to emotion mind
Identifying and labelling emotions - I highly recommend posting an emotion wheel on your bathroom mirror or somewhere easily accessible!
Check the facts and cognitive distortions (overlapping skills from DBT and CBT, respectively)
Opposite action - beware common pitfalls and misinterpretations of this skill-
Opposite action isn't for making yourself do things you don't want to do. Instead, the goal of opposite action is to change your current emotional experience
For opposite action to work, we need to do it all the way. No half-assing it!
Balancing interpersonal priorities (here is the full interpersonal effectiveness module)
A few words of caution:
There's no replacement for learning the skills in their entirety, then picking and choosing what elements work best for you
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
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
Lower-cost Therapy
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:
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
Consejo Counseling and Referral Services - focuses on Latinx community
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"
Self knowledge and self esteem
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:
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.
Disordered Eating and Body Image
Debunking fatphobia and bogus science:
BMI (Body Mass Index) - why it sucks and isn't an accurate measure of a person's health
From FiveThirtyEight
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
Under construction/coming soon
Resources for the following:
Polyamory
Kink
LGBTQIA+
Parenting teens
Adulting, everyday tasks, and executive function