Between Sessions offers self harm resources so you can help your teen patients deal with this issue in and out of session. Discover therapy activities for teens who are in danger of self-harming, written by professional therapists who understand what you need for your patients. Download counseling worksheets, handouts, audio files, and more to help patients build the tools they need to overcome the urge to self-harm. Be sure to look at our resources for sessions with adults who self-harm, too.

Increasing Positive Feelings — This worksheet is designed to evoke positive feelings and simultaneously demonstrate that you can “change the channel” on your emotions. PDF (0216, depression, CBT, positive psychology)

Creating Your Future — This worksheet is designed to help individuals think about their future and see that they have the power to create the kind of lives they want. PDF (quick, 1015, values clarification)

Your Most Memorable Dream — There are some dreams you find hard to forget. What makes these dreams so memorable? This worksheet can help you find out. PDF (quick, 1015)

Thinking About Your Emotional Strengths — This worksheet is designed to help people think about their emotional strengths and how they can bring these strengths to their current problems. It contains a list of strengths for clients to rate, as well as questions about how significant others perceive the person’s emotional strengths. Form Type: PDF (0415) ACT, DBT

bullet Assessments
5-Step Suicide Evaluation Procedure — This 5-Step Assessment Procedure is considered the best-practice for mental health professionals in assessing a client’s risk of suicide. (PDF) 0713

Suicide Risk Factors — This form can be used to assess specific risk factors in clients who have talked about suicide. Form Type: PDF (0515)

bullet Audio File
Walk Through the Forest Guided Imagery (Audio) — This guided imagery audio can be used to teach relaxation skills as a way to cope with anxiety, depression, physical problems, emotional volatility, and stress related disorders. Running time: 8.5 minutes.

Mindfulness Exercise For People Who Self-Injure (Audio) — This audio was developed for people who self-injure. The script asks listeners to set their intention to stop hurting themselves and treat their bodies with respect. It combines the techniques of mindful awareness and progressive relaxation technique.

Mindfulness - Just this Breath (Audio) — This 7-minute mindfulness audio file is designed to help people experiencing emotional distress by providing them an opportunity focus on the present. The audio is courtesy of Dartmouth College Health services with a script made at Georgia Southern University Counseling Center. Editing by Martin Grant.

Five-Finger Relaxation Exercise (Audio) — This six-minute audio file guides listeners toward a state of relaxation and well-being by having them imagine four scenes from their past using visual, audio, and kinesthetic images. This technique was developed by Dr. David Cheek and recorded by Dartmouth College Health Services. It was edited by Martin Grant.

Mindful Meditation (Audio) — This audio was produced by Dartmouth College Health Center, and can be used with clients as an introduction to the technique of Mindful Meditation. The background music is from “ERH” on the FreeSound Project. Editing by Martin Grant. Time: 31 minutes.

bullet Ebooks
Body Image Toolkit — This workbook consists of 17 interactive activities to help teens develop a better body image. This resource was developed to help all teens develop a healthy body image but would be particularly appropriate for teens who have eating disorders or other mental health problems related to a poor self-image. Form Type: PDF (0315)

bullet Games
Thinking About Emotions Game — This worksheet is designed to help people think and talk about their feelings. Players pitch a penny on the worksheet and then talk about the feeling where the penny lands. The game can be played in a small group or even by an individual. (emotional intelligence, depression, communication, social skills, 0317)

bullet Story
Acting Opposite to Your Impulses — If you find that your emotions are causing you to behave in ways which are self-defeating, you can use this worksheet to find out what happens if you do the opposite of what you would normally do. (DBT, CBT, Behavior Program, 1016)

bullet Worksheets
Observing and Accepting Your Emotions — This worksheet is designed to help people learn to observe and better understand their overwhelming emotions and the way they cope with them. (DBT, Emotional Regulation, 0320)

Fighting Depression Score Card — This worksheet challenges depressed clients to do 10 things each day to fight their depression and to keep track of their behaviors and moods for a month. The suggested activities are known to increase mood elevating biochemicals in the brain. The activities will also help people with anxiety and other mental health problems (1019).

Creating a Crisis Survival Plan — This worksheet is designed to help people create a Crisis Survival Plan for when their regular coping skills and strategies don’t work. (DBT, suicide, self-harm, self-injury, 0419)

Mood Diary — This simple Mood Diary can help clients keep track of their predominant mood each day, what influenced their mood, and what they did in response to their mood. (0219, emotions, log)

Controlling Your Hair Pulling — This worksheet is designed to help people determine if hair-pulling is a serious problem. The worksheet also teaches a behavioral technique commonly used to treat this problem. (anxiety, trichotillomania, habits, 0219)

Using Opposite Action to Deal with Difficult Emotions — This worksheet is designed to teach people the DBT skill of “opposite action” where you practice the opposite behavior that you would normally use when dealing with powerful emotions. (emotional regulation, 0119)

How Do You View Yourself? — This worksheet is designed to help people develop a positive self-image using 12 assignments including developing a kinder inner voice, understanding what you can control and what you can’t, avoiding comparing yourself to others, and more. (self-esteem, positive psychology, depression, anxiety, 1218)

Increasing Your Self-Esteem — This worksheet is designed to help people identify ways to improve their self-image and reduce self-criticism. (self-esteem, positive psychology, depression, 1218)

Recognize and Appreciate Your Resilience — This worksheet is designed to help people understand the concept of resilience and focus on the character traits that make them more resilient. (Solution-Focused, positive psychology, self-esteem, 1118)

Learning to Focus On Your World Rather Than Your Anxious Thoughts — This worksheet is designed to help people overcome their anxiety by practicing mindfulness, paying attention to their world through all five senses. (GAD, 0818, intrusive thoughts)

Responding and Not Reacting to Feelings — This worksheet is designed to help people respond to difficult situations in a positive way rather than mindlessly reacting in ways that might be self-destructive or destructive to others. (0718, anger control, addictions, impulsivity)

Activities That Help Counteract Your Stress — This worksheet is designed to help people identify daily activities which can help reduce the effects of chronic stress (anxiety, wellness, prevention, 0817)

Practicing Compassionate Self-Care — This worksheet helps people learn to treat themselves with more compassion, much like they would treat a loved one in need. (depression, self-care, 0517)

How Do You Want to Be Treated? — This worksheet is designed to help people think about how others can help them with their psychological problems. The worksheet asks them to think about both the things that they want from others as well as the things they don’t want. (depression, social skills, communication, 0417)

Practicing Self-Calming and Self-Caring Techniques — This worksheet is designed to encourage people to practice both self-care and self-calming techniques on a daily basis. The worksheet lists types of techniques are effective in each category and includes a form to record the use of these techniques for 21 days (the time it takes to form a habit). (PTSD, depression, anxiety, eating disorders, 0217)

Creating A Better Day — This worksheet is designed to help depressed clients become more active. The first page asks the user to think of various meaningful activities that they enjoy doing. The second page asks the user to schedule at least two activities to do each day for a week. (depression, CBT, 0217)

Developing Your Nurturing Inner Voice — This worksheet is designed to help people replace a critical inner voice with a more nurturing one. It asks the user to imagine a caring person in his or her life and internalize what this person is saying along with the feelings these statements engender. PTSD, depression, CBT, 0117)

Controlling Your Urges — This worksheet is designed to help people control their urges by activating the thinking part of their brains and make decisions that will interrupt the cycle of self-defeating behaviors. (addiction, self-control, impulse control, 0816)

The Costs and Benefits of Your Problem Behaviors — This worksheet is designed to help people develop insight into their problem behaviors, including the positive as well as the negative consequences. The worksheet is intended to help people step back from just judging themselves negatively and to see how their problem behaviors play a functional role in their daily lives. This worksheet can be used in writing a CBT oriented treatment plan. (CBT, DBT)

Learning to Accept Reality — Learning to accept reality is an important part of living in the present. Distorting reality can lead to depression, anxiety, disappointment in your relationships and more. This worksheet has three parts to help people understand how they distort memories from their past, events in the present, and thoughts about their future. PDF (DBT, CBT, Thought-Changing)

Building Body Acceptance — This tool was prepared by the Australian Center for Clinical Interventions and is intended to help people learn to challenge their faulty assumptions about their bodies. It will be helpful for many people who dwell on the imperfections of their body, but particularly those with Body Dysmorphia Disorder. (OCD, anxiety disorders, eating disorders, self-injury, 0716).

Loving Kindness Meditation — This worksheet is designed to teach people the technique of Loving Kindness Meditation. Research suggests that this simple meditation can have a long term effect on people’s happiness. PDF (ACT, meditation, happiness, depression, 0616)

Compromising With Yourself — This worksheet is intended to help people make compromises rather than be stuck between two extreme positions. PDF (DBT, CBT, problem-solving)

How Do You Deal with Emotional Pain? — This worksheet can be used to help people record the thoughts, feelings, sensations, and memories that caused them emotional pain as well as to note what behavioral responses are triggered and whether these were positive or negative. PDF (0316, DBT, Emotional Regulation)

Soothing Yourself When You Are Upset — Learning to calm down when you are upset is a critical part of emotional intelligence. This worksheet shows seven activities that trigger the production of biochemicals which calm the mind and body A second page asks people to keep track of which activities they use and how these activities affect their mood. PDF (0316, DBT, ACT, emotional regulation)

Take A Break From Stress — Take a vacation from stress and dedicate just one day to living “stress free.” Sometimes this is harder than you think! At the end of the day, think about how you were able to create stress-free time, and how you can apply this to your normal life. Stress is a normal part of life and learning to control and cope with stress is an important part of good mental health. PDF

Building Your Support System — This worksheet is designed to help people think about the people in their support system and the kinds of support they might be missing. PDF (0116)

Thinking in Full Color — This worksheet is designed to teach to avoid looking at their problems with absolute (black and white) thinking. Absolute thinking distorts reality and limits choices. People are asked to identify a problem, think of four “black and white statements” that pertain to that problem, and then change those thoughts to “full color.”

Focusing On Solutions — This worksheet will help you start thinking about how you solved problems in the past and how your life can be better today when you make even small changes. Focusing on solutions, rather than dwelling on your problem, can open many new possibilities. PDF (solution oriented therapy, problem solving, positive attitude, 0116)

Your Family Tree of Character Strengths — This worksheet is designed to help people identify the people in their families who help shaped their character. PDF (0116)

Brainstorming Solutions To Your Problems — This brainstorming technique asks people to identify a specific problem and then come up with 10 uncensored solutions while they complete a mindful "coloring activity." PDF (0116)

What Did You Learn in Grade School? — This worksheet asks people to think back to their years in grade school and the “life lessons” they learned. Answering the questions on this worksheet will likely bring up other thoughts and memories about what happened in these childhood years. (PDF 0115)

How Do Others See You? — The first part of this worksheet asks people to answer questions about themselves and then a second part can be used to ask the same questions to others. The worksheet is intended to help people see if their perception of themselves is very different than how others see them (PDF, 1215)

What Makes You Feel That Way? — This worksheet can help people gain insight into what triggers different emotions. PDF (1215)

Understanding Your Moods — This worksheet is designed to help people be more aware of their moods and realize that they have the power to change them. PDF

Just Scribble — This worksheet can be used for two purposes: to help people relax when anxious or stressed and to help people think about their feelings. PDF (1116, relaxation, insight)

Just 3 Words — This worksheet is designed to help people gain insight into their values and how they incorporate them into their daily lives. PDF (1112, ACT)

Make a Movie of Your Life — This worksheet is designed to help people think about and communicate important aspects of their self-image. The worksheet asks a people to name a movie about their life and draw a picture of the most important scene. PDF (quick, Narrative Therapy, 1015)

10 Things That Give You Pleasure — When people are depressed or going through a difficult time they often forget they have the power to make themselves feel better. This worksheet asks people to list 10 things that give them pleasure and to do at least one every day. PDF (quick, 1015)

Looking At the Timeline of Your Life — This worksheet suggests five activities that can help people get a “bird’s-eye view” of their lives as they note events and milestones at different ages. Suggestions for the worksheet include: listing positive events at different stage of life, listing influential people at different stages of life, anticipating future milestones and more. PDF (1015)

Be Aware of Your Strengths — This worksheet is designed to help people see how their character strengths can be important in seeing solutions to daily problems. PDF (ACT, 1015)

Connecting To A Higher Power — This worksheet is designed to help people explore their connection to a higher power, and to think about whether that connection can help them in difficult times. PDF (DBT, 0915

The Miracle Question — This worksheet asks people to think about how their lives would change if a miracle happened and their most pressing problems no longer existed. This exercise can be the start of a conversation to help people see ways to live without being overwhelmed by problems. PDF. (Solution Focused Therapy, quick, 0915)

Create a Positive Self-Portrait — This simple art therapy technique can help people focus on their positive qualities and how these qualities are visible to others. Form Type: PDF (Art Therapy, Quick, 0815).

Draw A Picture Of Your Family — This classic projective technique asks a client to: to “draw a picture of your family doing something.” Besides using it for assessment, you can also use it to start a conversation about the client’s perceived role in the family, feelings about other family members, relationship to other family members, and so on. Form Type: PDF (Art Therapy, Quick, 0814)

Create A Mandala — This simple art therapy exercise can help people get in touch with the feelings and can be used with clients to start a conversation about their self-image. Many therapists use this activity as part of a healing process. (Art Therapy, quick, 0815)

Prescriptions For Happiness — You can use this worksheet to create a prescription pad of simple research-based assignments that are associated with increased happiness and a positive attitude. PDF (behavior assignments, quick, 0815)

Write A Letter To Your Problem — This Narrative Therapy technique is designed to help people externalize a specific problem and motivate them to develop new behaviors to help overcome it. (Narrative Therapy, Quick, 0815)

Write Down Your Most Powerful Dream — This worksheet asks people to write down a powerful dream from the past. It also asks them to think about how the dream affected them. Form Type: PDF (Quick, NLP, Emotional Intelligence, 0815)

Imagining Your Best Possible Self — This writing assignment can encourage optimism and positive thinking. Form Type: PDF (0815, Narrative Therapy, Quick)

Take A Break — This worksheet encourages people to take a day off from their stress and dedicate that one day to relaxing. Form Type: PDF (Quick, Solution Focused)

What Are Your Positive Psychological Skills? — This worksheet is designed to help people see their positive psychological skills and apply them to their current mental health issues. Form Type: PDF (0815, Solution Focused)

Do Something Different — This simple behavior assignment can help people who feel they are stuck in unhealthy patterns. Form Type: PDF (0815, quick assignment)

Understanding Your Emotions When You Are Upset — This worksheet is designed to help people understand their emotions when they are upset and learn positive coping techniques to handle difficult emotions. Form Type: PDF (0715)

Creating A Personal Mission Statement — This worksheet is designed to help people clarify their purpose in life. The worksheet includes a serious of questions to help people develop a meaningful personal mission statement in just a few sentences. Form Type: PDF (0715)

Finding Joy and Balance In Your Life — This worksheet describes a daily technique to help people be mindful of the positive things in their lives. This technique is particularly important for people who are stressed and depressed, but it should also be considered a resiliency tool which can help you find daily happiness in your life. Form Type: PDF (0615)

Coping Cards — These Coping Cards can be used by people who want to replace negative behaviors with positive ones. A useful technique to help in breaking negative habits. Form Type: PDF (CBT, 0615)

Asking for What You Want & Need — This worksheet is designed to help people think about how assertive they are when they ask for something. Form Type: PDF (DBT, 0615)

Feeling Better Through Spiritual Awareness — This worksheet is designed to help individuals who wish to bring spirituality into their lives as a way to help them with emotional problems and enrich their day-to-day lives. Type: PDF (0515)

The Cost of Avoiding Difficult Feelings — Some people spend a lifetime trying to avoid the things that cause upsetting thoughts, feelings, sensations, or memories. This can help them manage their symptoms, but it can simultaneously lead to a very restricted and unhappy life. This worksheet is designed to help people identify the things that upset them, think about the things they do to avoid being upset, and think about what life would be like if they could overcome their symptoms. This worksheet can be used as a prelude to Mindfulness and other techniques that help people accept and overcome their symptomatic behaviors. (CBT, DBT, 0415).

Dealing With Shame and Guilt — This form is designed for people who blame themselves as solely responsible for a particular situation or event. The form is intended to help relieve the shame and guilt that make life unbearable. Form Type: PDF (CBT-0415)

Tolerating Upsetting Thoughts & Feelings — This worksheet helps people deal with difficult thoughts and feelings by having them focus on their core values rather than rely on self-destructive symptoms. There are two forms to complete, one to help people identify their core values and another to help them determine how much time they spend in activities that reflect these values. Form Type: PDF (0415-ACT)

Think Before You Act — This form can be used to give people a visual reminder to stop and think before they act. This is particularly helpful for kids and teens, but is a useful technique for adults too. Form Type: PDF (0315)

Creating An Emotional Emergency Kit — Some people are prone to becoming overwhelmed by their emotions. Usually caused by specific triggers, their intolerable level of emotions may then lead to symptoms, such as panic, alcohol or substance abuse, self-injury, or depression. This worksheet is designed to help people develop a set of positive coping techniques that can help them tolerate difficult emotions and refrain from self-defeating behaviors. (0315)

Talking About Your Emotions Helps You Manage Your Anxiety — This worksheet is designed to help people identify their moods during the day and talk about their feelings to someone else. Copies should be made, and the worksheet should be used for a minimum of seven days. Type: PDF (0315)

Avoiding Things You Can Use To Hurt Yourself — This worksheet is intended to help clients who self-injure learn to avoid the objects they commonly use to hurt themselves. It will be most effective when used with a comprehensive safety plan. Form Type: PDF (0215)

Enhancing Self-Esteem By Changing Negative Thoughts — This worksheet can help people identify and change the negative self-talk that can lead to low self-esteem. Form Type: PDF (0215)

The Grounding Technique — Grounding techniques are often recommended for clients who feel overwhelmed by their thoughts and feelings. This pdf includes a worksheet to help clients practice this technique and a link to a video demonstration of the technique. File Type: PDF (1214)

Cognitive Distortions & Your Body Image — This worksheet is designed to help clients corrected distorted thinking about their bodies. The worksheet provides several examples of common distorted thoughts people have about their bodies and gives them examples of corrected responses. Form Type: PDF (1214)

Deep Breathing for Stress Relief — This worksheet describes the four basic steps of relaxing through deep breathing. The worksheet links to a 13-minute exercise for clients to practice deep breathing, led by Dr. Lillian Cheung, of the Harvard School of Public Health. Type: PDF

Your Perceptions About Yourself — This worksheet asks clients to think about themselves objectively, based on the facts in their lives rather than on a subjective interpretation of their experiences. This exercise is derived from Acceptance and Commitment Therapy (ACT). Type: PDF (1114)

Accepting Unpleasant Experiences — This worksheet, derived from Acceptance & Commitment Therapy (ACT), is designed to help people accept unpleasant internal experiences, and not use them as an excuse to avoid life-affirming situations. Type: PDF (1114)

If the Problem Were A TV Show — This worksheet is a Narrative Therapy technique which can be used to help clients get more perspective on their presenting problem and see that they have the power to change their “life story" Type: PDF (1114)

The Tree of LIfe — This exercise is designed to help clients communicate positive aspects about their lives. The technique is derived from Narrative Therapy. Type: PDF (1114) Type: PDF

How Do You Deal With Conflicts? — This short questionnaire gives clients the opportunity to identify their behaviors and attitudes as assertive, aggressive, passive, or passive-aggressive, and provides some information about conflict strategies. File Type: PDF

Recording Dysfunctional Thoughts — This form can be used to by clients to record and change dysfunctional thoughts and to see how these thoughts affect their moods. PDF

Identifying Your Support System — This worksheet is designed to help people identify a support system of individuals they can contact in times of emotional distress. PDF

Making Positive Statements About Yourself — This worksheet encourages people to make positive statements about themselves. Form Type:PDF

Pushing Your Anger Buttons — This worksheet is designed to help people identify situations or events that trigger their anger. Form Type: PDF

Emotions Below The Tip of The Iceberg — This worksheet is designed to help people identify emotions that they hide from others. Form Type: PDF

Understanding Why You Hurt Yourself — This worksheet helps people think about the reasons they self-injure. PDF

Telling Your Parents That You Hurt Yourself — This form is designed to help teens who self-injure tell their parents about this problem. PDF

Avoiding Things You Use to Hurt Yourself — This worksheet is designed to help people who self-injure make harmful objects less accessible. PDF

Understanding Your Self-Esteem — This worksheet is designed to help people see if they perceive their positive and negative qualities accurately. PDF

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