phq9 last 2 weeks - ierha.ca
TRANSCRIPT
Name: ______________Date________
PHQ9:Over the last 2 weeks, how often have you been bothered by any of the following problems?
If you checked off any problem on this questionnaire so far, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
☐ Not difficult at all ☐ Somewhat difficult ☐ Very difficult ☐ Extremely difficult
GAD-7:Over the last 2 weeks, how often have you been bothered by the following problems?
If you checked off any problem on this questionnaire so far, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
☐ Not difficult at all ☐ Somewhat difficult ☐ Very difficult ☐ Extremely difficult
Notat all (0)
Severaldays (1)
More than half the days (2)
Nearly every day
(3)a. Little interest or pleasure in doing things.
☐ ☐ ☐ ☐b. Feeling down, depressed, or hopeless.
☐ ☐ ☐ ☐c. Trouble falling/staying asleep, sleeping too much.
☐ ☐ ☐ ☐d. Feeling tired or having little energy.
☐ ☐ ☐ ☐e. Poor appetite or overeating.
☐ ☐ ☐ ☐f. Feeling bad about yourself, or that you are a failure, or have
let yourself or your family down. ☐ ☐ ☐ ☐g. Trouble concentrating on things, such as reading the
newspaper or watching TV. ☐ ☐ ☐ ☐h. Moving or speaking so slowly that other people could have
noticed. Or the opposite - being so fidgety or restless that youhave been moving around more than usual.
☐ ☐ ☐ ☐
i. Thoughts that you would be better off dead or of hurtingyourself in some way. ☐ ☐ ☐ ☐
Over the last 2 weeks, how often have you been bothered by the following problems?
Not at all sure (0)
Several days (1)
Over half the days (2)
Nearly every day (3)
1. Feeling nervous, anxious, or on edge ☐ ☐ ☐ ☐2. Not being able to stop or control worrying ☐ ☐ ☐ ☐3. Worrying too much about different things ☐ ☐ ☐ ☐4. Trouble relaxing ☐ ☐ ☐ ☐5. Being so restless that it's hard to sit still ☐ ☐ ☐ ☐6. Becoming easily annoyed or irritable ☐ ☐ ☐ ☐7. Feeling afraid as if something awful might happen ☐ ☐ ☐ ☐
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Class 8
Name/ID: ______________________ Date: ____________________
Original DERS (36 item) Citation: Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54.
DERS-18 (18 item) Reference: Victor, S. E., & Klonsky, E. D. (2016). Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-18) in five samples. Journal of Psychopathology and Behavioral Assessment, in press.
DERS-18
Response categories:
1 2 3 4 5 Almost Never
(0-10%) Sometimes (11-35%)
About Half the Time (36-65%)
Most of the Time (66-90%)
Almost Always (91-100%)
1. __________ I pay attention to how I feel.
2. __________ I have no idea how I am feeling.
3. __________ I have difficulty making sense out of my feelings.
4. __________ I am attentive to my feelings.
5. __________ I am confused about how I feel.
6. __________ When I’m upset, I acknowledge my emotions.
7. __________ When I’m upset, I become embarrassed for feeling that way.
8. __________ When I’m upset, I have difficulty getting work done.
9. __________ When I’m upset, I become out of control.
10. __________ When I'm upset, I believe that I will remain that way for a long time.
11. __________ When I'm upset, I believe that I'll end up feeling very depressed.
12. __________ When I'm upset, I have difficulty focusing on other things.
13. __________ When I'm upset, I feel ashamed with myself for feeling that way.
14. __________ When I'm upset, I feel guilty for feeling that way.
15. __________ When I'm upset, I have difficulty concentrating.
16. __________ When I'm upset, I have difficulty controlling my behaviors.
17. __________ When I'm upset, I believe that wallowing in it is all I can do.
18. __________ When I'm upset, I lose control over my behaviors.
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Class 8
Managing Difficult Emotions: Education Classes
Session 8 –Interpersonal Effectiveness
Classes developed by Natalie Mota, PhDadapted from: Linehan, M. (2014). DBT Skills Training Manual.
Please Complete Symptom Measures• There is a link in your e-mail• There are paper copies if you received materials
by mail• QR code
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Before we Begin
• Please ensure that you are in a private space
• Turn off cell phones, TVs, radios, and otherdistractions
• Please do not share with the class personalstories of trauma or suicidal or violentthoughts
• If you are distressed, please contact theInterlake-Eastern RHA 24 hour Crisis Line at1-866-427-8628
What do I need for this Online Class?
• Personal web-enabled device or telephone
• Headphones
• Presentation Slides (digital copy or printedcopy)
• Pen and Paper
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Technical Information
• Remain muted unless speaking
• You may choose to turn your video on or offthroughout the class
• The host may control your microphone andvideo if necessary
• Do not take screenshots or record any partof the meeting
Technical Information
• If you have a question, please let the hosts(“raise your hand”, verbally, or chat)
• Technical disruptions may occur• If you get disconnected, please try to re-
join via e-mail link or by phone
• If you need assistance with technical issuesplease contact:
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Important Information
• We have taken safeguards to protect your privacy by:• Using first names only• Using a fully encrypted connection• Not allowing recording of any kind
• All of the information presented is based on evidence-based practice.
• Services are voluntary - you can choose to stop participating at any time
Confidentiality• Please respect everyone’s confidentiality – do not
share other group members names or other identifying information with people outside the group
• As with any on-line program, absolute confidentiality cannot be guaranteed
• Limits of Confidentiality:• when there is a risk of harm to yourself or
someone else• when there are concerns about a vulnerable
person• if records are ordered by a court
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Mindfulness Exercise
Practice Review
` Practice at least one DEAR MAN, GIVE, FAST skill per day
` Comment on your experience?` What worked well?` Any problems/obstacles?
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Interpersonal Effectiveness
` Goals of Interpersonal Effectiveness:` How to express your opinions effectively` How to say “no” effectively` Make the relationships you care about stronger` Make new relationships` End unhealthy or hurtful relationships
Based on Linehan, M. (2014). DBT Skills Training Manual. New York: Guilford Press.
Interpersonal Effectiveness
` Ending destructive or interfering relationships:` What is the problem with the relationship? Put it
into words` Is it something that can be fixed? If so, engage in
problem-solving` Pros and cons of ending the relationship
Based on Linehan, M. (2014). DBT Skills Training Manual. New York: Guilford Press.
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Interpersonal Effectiveness
` Ending destructive or interfering relationships:` Be in WISE mind, not in emotion mind` Practice what you’re going to say beforehand to end
the relationship` Be direct – Use your DEARMAN skills` Safety first!
Based on Linehan, M. (2014). DBT Skills Training Manual. New York: Guilford Press.
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Interpersonal Effectiveness
` Beginning New Relationships:` Look for others who live nearby (e.g., school, work,
go to the same coffee shop, etc.)` Look for others who have similar interests and
points of view` Keep practicing your conversation skills` Look for opportunities to genuinely compliment
someone` Join in if it looks like an open group!
Based on Linehan, M. (2014). DBT Skills Training Manual. New York: Guilford Press.
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Practice
` Start one new conversation (can be small talk!) with someone new
Great websites:` http://www.dbtselfhelp.com/html/mindfulness1.html
` www.takingcharge.csh.umn.edu – Taking Charge of your Health and Wellbeing
Reflections on Class
` What have you learned?` How have you changed?` What to maintain?` Areas that are still a concern?` What are your next steps?
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Final Thoughts
` Thank you for your participation!
` Please complete questionnaires/evaluations
` Please let us know if you are interested in attending another round of MDE classes
` Contact your Community Mental Health Worker if you require further follow-up.
Please complete evaluation
• There is a link in your e-mail• There are paper copies if you received materials by
mail• QR code`
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From DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permis-sion to photocopy this worksheet is granted to purchasers of DBT Skills Training Handouts and Worksheets, Second Edition, and DBT Skills Training Manual, Second Edition, for personal use and use with individual clients only. (See page ii of this packet for details.)
INTERPERSONAL EFFECTIVENESS WORKSHEET 10 (p. 1 of 2)
(Interpersonal Effectiveness Handout 13 ; p. 145 )
Ending Relationships
Due Date: Name: Week Starting:
Fill out this sheet to outline how to end an unwanted relationship when the relationship is not abu-sive. If it is abusive, first call a local domestic violence hotline or the National Domestic Vio-lence Hotline (1-800-799-7233). Write on the back of this sheet if you need more room.
Relationship problem: Describe how the relationship is destructive or interfering with your life.
List Wise Mind pros and cons for ending the relationship.Pros:
Cons:
Script Ideas for DEAR MAN, GIVE FAST to End a Relationship
1. Describe the relationship situation, or the problem that is the core reason you want to end the relationship.
2. Express feelings/opinions about why the relationship needs to end for you.
3. Assert in your decision to end the relationship directly (circle the part you will use later in “broken record” to stay mindful if you need it).
4. Reinforcing comments to make about positive outcomes for both of you once the relationship is ended.
(continued on next page)
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INTERPERSONAL EFFECTIVENESS WORKSHEET 10 (p. 2 of 2)
5. Mindful and Appearing confident comments to make about how and when to end (ifneeded).
6. Negotiating comments to make, plus turn-the-table comments to avoid getting off track andresponding to insults or diversions (if needed).
7. Validating comments about the other person’s wishes, feelings, or history of the relationship.
8. Easy manner comments.
9. Fair comments.
Check off opposite actions for love you have been doing:
�� 1. Reminded myself why love is not justified.
�� 2. Did the opposite of loving urges.
�� 3. Avoided contact with reminders of loved one.
�� 4. Other:
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From DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permis-sion to photocopy this worksheet is granted to purchasers of DBT Skills Training Handouts and Worksheets, Second Edition, and DBT Skills Training Manual, Second Edition, for personal use and use with individual clients only. (See page ii of this packet for details.)
INTERPERSONAL EFFECTIVENESS WORKSHEET 8(Interpersonal Effectiveness Handout 11; p. 140–141 )
Finding and Getting People to Like YouDue Date: Name: Week Starting: Fill out this sheet whenever you practice finding friends and whenever you have an opportunity to practice, even if you don’t (or almost don’t) do anything to practice. Write on the back of this sheet if you need more room.List two ways you could (or do) make casual but regular contact with people.1. 2. List two ways you could find (or have found) people whose attitudes are similar to yours.1. 2. List two ways you could get in conversations (or have been in them) where you could ask a question, give an answer, give a compliment, or express liking to others.1. 2. List times you have been near a group conversation you could practice joining (or how you could find one).1. 2.
Check the facts and be sure you have listed all of your opportunities to find potential friends. Add more ideas if necessary or ask your current friends or family for ideas.
Describe one thing you have done to make a new friend and get someone to like you.
Check off and describe each skill that you used. Proximity Similarity Conversation skills Expressed liking
Describe any efforts you made to join a conversational group.
Describe any efforts you made to use your conversation skills with others.
How effective was the interaction?
Text
143
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Class 8 Date:_____________________
EVALUATION of the Managing Difficult Emotions Session
1. How did you attend the class? ○ Phone ○ Video
2. How useful was the session for you? (circle one number)
Not very useful Extremely useful
1 2 3 4 5
3. What is the one skill you learned today that you could apply this week?
4. What did you like about this session?
5. How could we improve the session?
6. Would you recommend this class to someone else? ○ Yes ○ No
7. Did you practice any skills from last class? ○ Yes ○ No
More on Back…
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The following questions are about your experiences with MDE as a whole.
The skills I learned in class helped to reduce my distress/symptoms:
Strongly disagree Strongly agree
1 2 3 4 5 The facilitators presented material in a way that was easy to understand:
Strongly disagree Strongly agree
1 2 3 4 5 Overall, material was presented at a pace that was easy to understand:
Estremely slow Extremely fast
1 2 3 4 5
Please indicate how helpful you found the following:
Mindfulness
○ Not Helpful at all ○ Somewhat Helpful ○ Helpful ○ Very Helpful
Distress Tolerance
○ Not Helpful at all ○ Somewhat Helpful ○ Helpful ○ Very Helpful
Emotion Regulation
○ Not Helpful at all ○ Somewhat Helpful ○ Helpful ○ Very Helpful.
Interpersonal Effectiveness
○ Not Helpful at all ○ Somewhat Helpful ○ Helpful ○ Very Helpful.
We would appreciate any additional comments that you may have regarding your experience of class (like/didn’t like, suggestions for improvement, practice assignments, etc.)
Thank you
148
DBT Skills Cheat SheetMindfulness Skills: Emotion Regulation Skills
Wise Mind Check the facts"WHAT" skills: Opposite action
* Observe: just notice Problem - solve* Describe: put into words, just the fact A - Accumulate positive emotions* Participate: enter into the experience B -Build mastery
"HOW" skills C - Cope ahead* Nonjudgmentally Reduce Vulnerability:* One-mindfully: present moment PL - treat PhysicaL illness* Effectively: focus on what works E - balance Eating
A - Avoid mood altering substancesS - balance SleepE - get Exercise
Mindful of current emotion; letting go of emotional suffering
Distress Tolerance Skills Interpersonal Effectiveness Skills
Crisis Survival DEAR MAN (Objective Effectiveness)STOP D - Describe the situation; just the facts
S - Stop, don’t react E - Express feelings and opinions; "I" statementsT - Take a step back A - Assert: ask for what you want; others not O - Observe mind readersP - Proceed mindfully R - Reinforce - rewards for self and others
PRO'S & CON'STIP M - stay Mindful: broken record; focus on goal
T- Temperature, cold water A - Appear confident: strong voice, posture, eyeI - Intense exercise contactP - Paced breathing; Paired muscle relaxation N - Negotiate: compromise; brainstorm solutions
Distract (ACCEPTS)A - Activities GIVE (Relationship Effectiveness)C - Contribute - volunteer/help someone G - Gentle: be kind & respectful; no attackingC - Compare - to another time; to those less I - Interested: listen, no interrupting; eye contact fortunate V - Validate: walking in their shoesE - different Emotion; books, movies, music E - Easy manner: humor, smile, no attitudeP - Push away; for a little away; pain on shelfT - Thoughts - peaceful place; loving kindness FAST (Self-Respect Effectiveness)S - Sensations - e.g.. Ice in hand, loud music F - be Fair: to yourself and others hot/cold shower A - no Apologies
Self-sooth -- five senses S - Stick t valuesIMPROVE skills T - be Truthful
I - Imagery: peaceful place; happy timeM - Meaning - in a difficult situationP - Prayer - any form of spiritualityR - Relaxing - calming activity (bath, yoga etc.)O - One thing in the moment (100% attention)V - Vacation: day off, phone off , mental vacationE - Encouragement: "I will be ok", "I am strong"
RADICAL ACCEPTANCE: "is what it is"; turning the mind; urge surfing; half-smile
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SAT
SUN
TIP
PM
ON
TU
EW
ED
TH
UR
FRI
SAT
SUN
Dis
tra
ct (
AC
CE
PT
S)M
ON
TU
EW
ED
TH
UR
FRI
SAT
SUN
.Se
lf-s
oo
th (
5 s
en
ses)
MO
NT
UE
WE
DT
HU
RFR
ISA
TSU
N
Imp
rove
th
e m
om
en
tM
ON
TU
EW
ED
TH
UR
FRI
SAT
SUN
RE
ALI
TY
Ra
dic
al a
cce
pta
nce
MO
NT
UE
WE
DT
HU
RFR
ISA
TSU
N
AC
CE
PT
INT
ER
PE
RSO
NA
L(objective)
DE
AR
MO
NT
UE
WE
DT
HU
RFR
ISA
TSU
N
EFF
EC
TIV
EN
ESS
:M
AN
MO
NT
UE
WE
DT
HU
RFR
ISA
TSU
N
(relatio
nship)
GIV
EM
ON
TU
EW
ED
TH
UR
FRI
SAT
SUN
(self-respect)
FAST
MO
NT
UE
WE
DT
HU
RFR
ISA
TSU
N
Va
lida
tio
nM
ON
TU
EW
ED
TH
UR
FRI
SAT
SUN
ABC
(Acc
um
ula
te p
osi
tive
em
oti
on
s, B
uild
ma
ste
ry,
Co
pe
ah
ea
d)
*0
= n
ot
he
lpfu
l
PLEA
SE (P
hys
ica
L ill
ne
ss,
Ea
tin
g, A
void
mo
od
-alt
eri
ng
sub
sta
nce
s, S
lee
p,
Exe
rcis
e )
3 =
ve
ry h
elp
ful
STO
P (S
top
, d
on
't r
ea
ct;
Ta
ke a
ste
p b
ack
; O
bse
rve
; P
roce
ed
min
dfu
lly)
TIP
(Te
mp
era
ture
, In
ten
se e
xerc
ise
, P
ace
d b
rea
thin
g, P
air
ed
mu
scle
re
laxa
tio
n)
ACCE
PTS
(Act
ivit
ies;
Co
ntr
ibu
tin
g; C
om
pa
riso
ns;
Em
oti
on
s; P
ush
aw
ay;
Th
ou
ghts
; Se
nsa
tio
ns)
IMPR
OVE
(Im
age
ry;
Me
an
ing;
Pra
yer;
Re
laxi
ng;
On
e t
hin
g; V
vaca
tio
n;
En
cou
rage
me
nt)
DEAR
(De
scri
be
, E
xpre
ss,
Ass
ert
, R
ein
forc
e)
MAN
(Min
dfu
l, A
pp
ea
r co
nfi
de
nt,
Ne
goti
ate
)
GIV
E (G
en
tle
, In
tere
ste
d,V
alid
ate
, E
asy
ma
nn
er)
FAST
(Fa
ir,
no
Ap
olo
gie
s, S
tick
to
va
lue
s, T
ruth
ful)
151