GinaMarie Guarino, LMHC
The first step to managing stress is learning how to recognize stress. Most people who experience symptoms of stress do not realize that it is a physiological reaction. They also do not realize how often daily occurrences can be triggers for stress. When working with a client who is struggling with stress-related issues, it is […]
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GinaMarie Guarino, LMHC
Dialectical behavioral therapy is particularly useful when it comes to teaching a client how to handle distressing or upsetting situations. DBT teaches coping skills for stress tolerance, emotional regulation, and the reduction of mood swings and panic attacks. DBT provides several different tools that help a person learn how to cope with upsetting emotions like […]
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GinaMarie Guarino, LMHC
When working toward learning steps to manage anxiety, it is important to learn how to challenge anxious thoughts. Anxious thoughts can stem from anywhere, and can affect a client at any time. Being sure that your client is well-equipped with coping strategies to manage anxious thoughts will have a major impact on how he or […]
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GinaMarie Guarino, LMHC
The Cognitive-Behavioral model is used in cognitive-behavioral therapy (CBT). It is a model used to explain the process of how CBT works and how it is helpful to utilize while in counseling. Often clients struggle to understand the meaning behind concepts in CBT, so it is helpful to have a visual aid that explains the […]
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GinaMarie Guarino, LMHC
When in recovery, it is important to have a safety plan. Patients who are in recovery will face many challenges, and most of them will be unexpected. This is why helping our patients be prepared for triggers, cravings and obstacles is critical for recovery. About This Worksheet This is the Relapse Prevention Plan worksheet. This […]
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GinaMarie Guarino, LMHC
At some point in a client’s journey, he or she will need to take a step back to evaluate how he or she is managing self-care. It is important for a client to be well-aware of what he or she needs to be able to maintain self-care, and to understand a hierarchy in which the […]
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GinaMarie Guarino, LMHC
Building self-esteem is an essential part of child development. Without developing a high self-esteem, a child has a higher risk of struggling with anxiety, depression, relationship issues, body image and many other challenges. These challenges will affect the quality of how the child lives his or her life. In order to be able to develop […]
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GinaMarie Guarino, LMHC
It is not uncommon for a child to struggle with verbalizing his or her fears. It can be a challenge for a child to face his or her fears, but setting up a child in a safe setting to express and explore the fears that he or she struggles with can facilitate growth and development […]
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GinaMarie Guarino, LMHC
It is important to have a list of goals and objectives for the client and therapist to work toward when beginning a new therapeutic relationship. Setting goals creates a foundation that helps the client and therapist stay on track when helping a client feel better. Setting goals also empowers a client to stay on track […]
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GinaMarie Guarino, LMHC
When working with kids and adolescents, especially those who have behavioral problems, it can be a challenge to teach empathy and healthy socialization skills. Being able to express gratitude and appreciation for others helps a child relate to children and how to identify positive qualities within themselves. When a child is able to express appreciation, […]
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GinaMarie Guarino, LMHC
Sometimes a client will struggle to overcome racing or ruminating thoughts. These thoughts can be frustrating for a client, and can prevent him or her from staying productive throughout the day. If a client is struggling with racing thoughts, it is important for him or her to learn skills to manage those thoughts. Managing the […]
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GinaMarie Guarino, LMHC
Arguments are never easy, but it is important to know how to effectively argue to keep lines of communication open. Often when people struggle with arguments the point of the argument is lost, which prevents the partners to find resolution. This is why it is important to learn how to effectively argue to find resolution […]
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GinaMarie Guarino, LMHC
In recent studies, it has been found that practicing gratitude exercises and positive affirmations have been effective in helping people manage stress, anxiety, depression, and an array of other types of mental health disorders. Teaching a client how to practice gratitude exercises helps him or her learn how to acknowledge and appreciate the good. This […]
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GinaMarie Guarino, LMHC
Promoting self-love is an important part of therapy, but sometimes can be a challenge for clients. It is a lesson that is dynamic, and should be treated as such. For a client to learn to love himself or herself, he or she must also learn how to love and appreciate those around him or her. […]
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GinaMarie Guarino, LMHC
Working on communication in relationships is an integral part in strengthening the bond between a couple. Often, people who are struggling in a relationship have a hard time expressing their needs in an open and effective way. This can often cause tension in a relationship and cause a rift between partners. About This Worksheet This […]
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GinaMarie Guarino, LMHC
It is important for clients to have an understanding of where logic meets feelings. These are two opposite elements that play a major role in how a client perceives a situation. In turn, it will facilitate how a client will react to a situation. In order to ensure behavior is healthy, appropriate, and promotes mental […]
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GinaMarie Guarino, LMHC
When working with clients on how to modify behavior, it is important to teach how to be self-reflective and aware of his or her behavior in reaction to the people places and things around them. When clients learn how to be self-reflective, they are able to learn how to slow down reactions, think situations through, […]
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GinaMarie Guarino, LMHC
A major part of learning how to cope with feelings and emotions in therapy is to understand how negative thoughts affect our thoughts and emotions. When a person is feeling a great deal of negative emotion, like anxiety, depression or anger, that person will also have negative thoughts. A major way to learn how to […]
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GinaMarie Guarino, LMHC
Teaching emotional intelligence skills is important when working with young children. Often children have feelings they may not understand, which makes it difficult for them to express how they are feeling and if they are upset. This struggle can prevent caretakers and parents from being able to understand the child’s needs, and can further complicate […]
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GinaMarie Guarino, LMHC
It is not uncommon to have a client pass through your doors who has low self-esteem and a poor awareness of who he or she is and how he or she fits into the world. This can cause a great deal of unpleasant feelings and anxiety within a person, as he or she struggles to […]
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GinaMarie Guarino, LMHC
Many of the clients that pass through therapy offices struggle a great deal with feeling safe in their own skin. Whether it is due to a history of trauma, personal insecurities, or just a general suspicion or lack of self-awareness, people often develop symptoms of anxiety and panic when confronted with different challenges. Sometimes, this […]
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GinaMarie Guarino, LMHC
Creating mantras is a great way to help your client learn how to cope and self-soothe when going about their day-to-day life. A mantra is a saying or phrase that is created and used by a person in times of distress, discomfort, sadness or anger. Mantras derive from meditative practices and have been found to […]
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GinaMarie Guarino, LMHC
When we are kids, we have a good grasp of what it means to experience those staple emotions: Happy, sad, angry, excited, etc. We learn about emotions slowly, what they mean, and how to manage them. As we develop, our brain expands, and our understanding of emotions and how we feel becomes more complex. For […]
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GinaMarie Guarino, LMHC
There are many reasons why rewarding systems and operant conditioning strategies can be beneficial for a client. Whether it is to learn new parenting skills, communication skills, or leadership skills, understanding the process of reinforcement and punishment styles can be instrumental in a client’s therapeutic process. While helpful skills to learn, understanding the difference between […]
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GinaMarie Guarino, LMHC
When confronted with a difficult situation or an uncomfortable feeling that is not easily resolved, it can be easy to fall into a pattern of ruminating over the discomfort. It creates an urgent need to resolve a situation or find a solution to help you feel better. As we move through life, we learn that […]
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GinaMarie Guarino, LMHC
We all know that sometimes life can get overwhelming. Whether it is stress at work, home, or from an unexpected circumstance that causes us to feel overwhelmed. Whatever the case, it is important to know how to manage the feelings of stress, anxiety, fatigue, and depressed mood that comes with difficult circumstances. We all have […]
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GinaMarie Guarino, LMHC
Emotional regulation is an important thing to learn when in therapy. Each of us experiences different feelings and different emotions for a wide array of reasons, and sometimes it can feel overwhelming and can be difficult to keep those feelings and emotions in check. Sometimes, these difficult emotions can lead to chronic feelings of depression, […]
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GinaMarie Guarino, LMHC
One of the hardest things for a client to work on is how to learn how to understand, regulate and control their emotions. Emotions are tough, and can often lead clients to behave in a way that is detrimental to themselves and others. A major goal for most clients is to learn how to regulate […]
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GinaMarie Guarino, LMHC
In successful therapeutic processes, there will come a point in which a client needs to learn how to maintain a healthy, positive lifestyle that promotes mental health and wellness. Clients learn a great deal while in therapy, and making sure that the skills they learn is important to ensuring the client’s successful completion. It is […]
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GinaMarie Guarino, LMHC
The way we think is a huge component that contributes to the way we feel, behave and react to situations. People develop habits in thinking. Sometimes those habits are healthy, but often people can develop erroneous patterns of thought that affect the way they perceive the world and their place in it. These thoughts are […]
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GinaMarie Guarino, LMHC
It can be easy to get wrapped up in the moment of a stressful situation and instantly feel overwhelmed and without direction or hopes of finding resolution. When dealing with stress it is important to keep in mind that it will trigger anxiety, and each person reacts to anxiety in different ways. It is important […]
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GinaMarie Guarino, LMHC
Sometimes when it comes to working on goals, it is difficult for a client to really understand what it means to set a goal and how to go about working toward that goal. Often times we think of goals as the end result, without considering the means to which we achieve the goal itself. Sometimes […]
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GinaMarie Guarino, LMHC
Sometimes it can be tough for our clients to know what words to use to express what they are feeling. Feelings and emotions are complex, and can sometimes be uncomfortable and overwhelming. When our clients struggle to articulate their feelings it can be helpful to provide a guide to help navigate them through the words […]
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GinaMarie Guarino, LMHC
Sometimes we have clients who struggle with finding motivation. They may struggle to find motivation in developing a career, accomplishing a goal, or moving on to the next phase in life. There are a number of reasons why a person may struggle with achieving a goal. This is why it is important that the client […]
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GinaMarie Guarino, LMHC
As therapists, we know that most issues and concerns our clients face are more dynamic and intricate than the client may realize. Many components contribute to presenting issues with our clients, and often there is more than meets the eye. When working with clients on issues like emotional regulation, mood disorders, anxiety, and self-esteem, it […]
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GinaMarie Guarino, LMHC
Sometimes clients struggle with learning how to feel happy and fulfilled in their lives. Whether it is due to depression, low self-esteem, or motivation issues, it is not uncommon for clients in therapy to struggle to find traction toward happiness or contentment. These clients will ultimately feel lost and sometimes hopeless in their efforts to […]
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GinaMarie Guarino, LMHC
When teaching a client how to use cognitive behavioral therapy (CBT) for managing anxiety it helps a great deal to provide a visual aid. Clients who suffer from severe or chronic anxiety struggle to maintain control over anxious thoughts and resulting anxious feelings and behavior. It is important to teach clients in CBT treatment to […]
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GinaMarie Guarino, LMHC
Sometimes our clients have a hard time expressing how they feel to their therapist and others. There could be several reasons for this, like the client was not brought up to express their emotions, they struggled to relate to how others feel, or they simply struggle to make the connection between feeling and expressing their […]
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GinaMarie Guarino, LMHC
There are a number or reasons why our clients develop a tendency of stunting their emotional expression. Many grow up in homes where they learn to silence their feelings, some suffer from mood disorders that cause unfamiliar feelings, and some come from traumatic, abusive, or negligent situations that prevent them from being able to understand […]
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GinaMarie Guarino, LMHC
Helping a patient build self-esteem can be a challenging process. Many patients suffer from poor self-esteem, and that poor self-esteem contributes to their presenting concerns. It also will hold patients back from reaching their full therapeutic potential and feeling confident in themselves to make the changes in their lives that will help them improve their […]
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GinaMarie Guarino, LMHC
Interpersonal issues like assertiveness, aggression, and confrontation are often things people struggle to know how to handle. There is a fine line between assertiveness and aggression, hostility, and submission, when dealing with confrontation. Sometimes it can be difficult to know which road to take, whether to be assertive, aggressive or submissive, and the confusion can […]
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GinaMarie Guarino, LMHC
We all know that worrying consumes time and energy, and is a feeling that is often hard to shake. Patients often struggle to cope with worrying, and may not even realize how severely they are affected by their worrying. do not quite understand that they have the power to control how their thoughts affect their […]
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GinaMarie Guarino, LMHC
When working with patients who struggle with relationship issues and communication issues, it is important to be sure the patient understands the core elements needed in developing relationships. Patients often struggle with building relationships, getting to know people, being open to others, and communicating. When patients struggle with these issues it is important to teach […]
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GinaMarie Guarino, LMHC
Many patients will struggle with a major issue that all people are best coming to terms with: we cannot control what happens around us. Wanting to remain in control is a natural thing for people, but it can sometimes be difficult for a patient to understand that they cannot control the environment or a situation, […]
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GinaMarie Guarino, LMHC
One major cause for stress for patients is understanding how to handle confrontation and interactions with others. Sometimes people struggle with being assertive, controlling their temper, or simply expressing how they are feeling or what they are thinking in a given situation. When patients struggle with such challenges it helps to help them understand social […]
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GinaMarie Guarino, LMHC
Cravings to engage in dangerous or indulgent behaviors like drinking, using drugs, overeating, or sex are a difficult thing for a patient to work through. Each time a patient experiences a craving or a trigger to engage in something they know is not good for them they are confronted with the conflict between doing what […]
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GinaMarie Guarino, LMHC
When it comes to teaching children proper behavior it helps a great deal to have a reward system in place in which the child can watch his or her progress grow. Such positive reinforcement helps with keeping children motivated to keep growing and working hard to learn good behavior and responsibility. Especially when dealing with […]
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GinaMarie Guarino, LMHC
Negative thoughts have the potential to control the way people perceive and interpret almost every aspect of their lives. Some may have negative thoughts about themselves, others, or the way of the world. Negative thoughts generate negative feelings, and negative feelings contribute to negative behavior and mood disorders. That is why it is important to […]
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GinaMarie Guarino, LMHC
It is important for children to feel empowered and confident in themselves. Confidence helps a child feel proud, motivates them to learn and engage with others, and helps them build social skills and resilience that will be useful in the real world. Unfortunately, many children find it difficult to identify their positive qualities and what […]
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GinaMarie Guarino, LMHC
It is sometimes difficult for to control anger. Whether it is an isolated situation or a long-term problem , triggers for anger have the potential to cause the affected to react in alarming and sometimes dangerous ways. Those who suffer from anger management issues find it difficult to understand and control their anger. That is […]
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GinaMarie Guarino, LMHC
It is important for therapists who are trained in cognitive behavioral therapy (CBT) to teach their patients how to deal with automatic negative thoughts (ANTs). ANTs are huge catalysts for negative behavior like lashing out at others and self-destructive behaviors. If a patient is able to identify and understand how ANTs are able to affect […]
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GinaMarie Guarino, LMHC
Cognitive behavioral therapy (CBT) is a very popular and effective treatment modality that is used for many different types of cases. Whether the patient has depression, anxiety, borderline personality, low self-esteem, poor impulse control, anger management issues or otherwise, CBT is an excellent form of treatment that provides the patient with tools needed to identify […]
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GinaMarie Guarino, LMHC
A major reason why patients suffer from low self-esteem or emotional issues is a poor sense-of-self. There are many reasons for a person to develop a poor sense-of-self, but one common reason being aware of or understanding the things they value in life. Helping a patient discover what is important to them and their moral […]
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GinaMarie Guarino, LMHC
There are many reasons why people tend to have trouble sleeping. Among the most common symptoms of insomnia or sleep issues is having racing thoughts right before going to sleep. Many clients will struggle with falling asleep because as they try to fall asleep they are overwhelmed with thoughts that seem to demand their attention. […]
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GinaMarie Guarino, LMHC
People who suffer from eating disorders have a difficult time staying on track with a healthy diet. Whether they are inclined to eat too much or not enough, it can be a difficult keep track of the progress they are making in their journey back to health. Often when a patient is first starting out […]
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GinaMarie Guarino, LMHC
Grief is one of the most difficult things in life that we have to go through. It is confusing, upsetting, painful, and sometimes traumatic. A child is especially affected by grief and loss because they do not understand they may not understand what it means to lose someone, and certainly do not understand how to […]
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GinaMarie Guarino, LMHC
Children find it hard to cope with things they do not understand. There are many people, places and things in the world that scare children, and when children are afraid they feel lost, alone and vulnerable. Children who are fearful have a hard time developing the confidence they need to face their fears, but if […]
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GinaMarie Guarino, LMHC
Working with children is as challenging as it is rewarding. As we know, children perceive and interpret their world very differently than adults. As children develop they begin to understand their lives and their influence on it in different ways. While they grow their understanding and expression of their emotions become more complex, which makes […]
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GinaMarie Guarino, LMHC
When patients suffer from more debilitating emotional issues like depression and severe anxiety it can be difficult for them to keep from falling into bad habits like isolating and cutting off things that bring them joy. Of course this is understandable, as with such mental illnesses it can be difficult for a patient to enjoy […]
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GinaMarie Guarino, LMHC
When we are confronted with a situation in which a patient is expressing to us that he or she is in danger of causing harm to himself or herself or is in danger of being harmed by someone it is important that as clinicians we do all we can do to keep our patient safe. […]
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GinaMarie Guarino, LMHC
It is always alarming when a patient comes into our office and begins to express plans or thoughts about harming himself or herself. We are trained as professionals to take any and all reports like this seriously and need to be able to collect all of the information we need to effectively and safely assess […]
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GinaMarie Guarino, LMHC
When we are confronted with patients who are fixated on the negative it is difficult to break away from the bad and shift focus on the good. Often we will have a patient who does not acknowledge anything besides the negative in his or her life which not only is detrimental to their overall health, […]
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GinaMarie Guarino, LMHC
One of the most important things we do as therapists is screen our patients to make sure they are safe after they leave our office. Whether the patient is struggling with depression, anger, eating disorders, substance abuse, family issues, abuse, or suicidal ideation, it is imperative that we make sure our patients are safe and […]
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GinaMarie Guarino, LMHC
In 1969, Dr. Elisabeth Kübler-Ross developed the 5 stages of grief. This is where the grieving process is broken down into 5 stages. These stages include denial, anger, bargaining, depression and acceptance. Each stage is a part of the difficult process of grieving that almost everyone who experiences loss faces. Although the theory behind the […]
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GinaMarie Guarino, LMHC
Sometimes when people suffer from low self-esteem, low confidence, or mood disorders like anxiety and depression it is easy to focus on the negative and forget about the positive that they have in their lives. When patients focus only on the negative it is hard to imagine a happy and positive life that has hope, […]
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GinaMarie Guarino, LMHC
When starting with recovery from substance use it is so important that the patient be able to identify and understand the people, places and things to avoid. The more a patient learns about sobriety and themselves the more they realize the patterns that people, places and things cause and how detrimental it is to their […]
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GinaMarie Guarino, LMHC
When a substance abuser first starts therapy it is important for both the therapist and patient to have a full understanding of the history and progression of the substance abuse. Such details as reasons behind first use, point in time where use increased, and difficulty with stopping use can be very telling when trying to […]
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GinaMarie Guarino, LMHC
When we are struggling with understanding our mood and emotions it helps a great deal to use a mood journal to keep track of daily activities, triggers from the day, and how we managed out feelings. Sometimes we get caught up in the day and forget to focus on what we are feeling, which causes […]
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GinaMarie Guarino, LMHC
Patients who are suffering from a mental illness can often feel discouraged from being able to achieve their goals. Sometimes their ambitions and efforts are cut off by thoughts like “why bother?”, “it’s too much, I won’t be able to do it” or “I will start tomorrow”. It helps a great deal to draft a […]
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GinaMarie Guarino, LMHC
With all the responsibilities we have as adults it is all too easy to get wrapped up in the stress of the day and miss out on the things we appreciate in this world. When a patient is overwhelmed with their environment it is helpful to remind them to focus on things that they appreciate […]
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GinaMarie Guarino, LMHC
Weekly mood charts are great ways to track the progress of a patient’s mood regulation exercises. With weekly mood charts the patient is able to record any successful or unsuccessful attempts of managing his or her moods and emotions. It is also very helpful for helping the patient identify his or her triggers and ability […]
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GinaMarie Guarino, LMHC
An important step to understanding your anger is understanding how intense it can become and the situations that make it as intense as it can be. Patients with anger management issues sometimes find it difficult to assess a situation and their reaction to the situation. An anger thermometer is a good way to help patients […]
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GinaMarie Guarino, LMHC
Anger is a difficult feeling to understand and control. When a patient suffers from anger management issues it is easy for them to identify through the feeling and behavior. Of course, holding on to anger is not a healthy habit, so we want to teach our patients a healthier way to handle emotions. In order […]
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GinaMarie Guarino, LMHC
Anticipatory anxiety is a struggle for many people. Often we see things like catastrophizing when people experience anxiety about upcoming events. When it comes to anticipatory anxiety the thought of the worst case scenario is enough to have a patient be overcome with worry, which will sometimes affect performance and their mental and emotional health. […]
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GinaMarie Guarino, LMHC
When a patient is learning what is affecting them and ways to feel better it is expected that they take lessons learned in therapy and to them to their lifestyles. Sometimes in the heat of emotions and stress patients can forget what they learned and how to implement them, and need a reminder of why […]
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GinaMarie Guarino, LMHC
Patients often have a pattern of how their mood affects them. Throughout the day there are certain triggers based on responsibilities, encounters, etc. that may cause a patient’s mood to fluctuate. It helps a patient prepare for triggers when they are aware of when and where they are likely to encounter a trigger, along with […]
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GinaMarie Guarino, LMHC
Often those with depression lose sight on what is important to them. Depression is mentally, emotionally, and physically debilitating and when a patient is depressed and does not understand what they can do to manage the depression the patient will feel hopeless about life and the future. It is important to encourage patients to find […]
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GinaMarie Guarino, LMHC
Like all mood disorders, it is important for the patient to really understand their depression, how it affects them, and how they help or hinder their ability to stay well when managing their depression. Often, people with depression feel hopeless to get better, which will prevent them from trying new things to manage their depressed […]
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GinaMarie Guarino, LMHC
Depression is arguably one of the most difficult disorders to cope with on a daily basis. Many patients with depression truly believe that they cannot get better, and therefore tend to not be very hopeful in therapy at first. It is because of this belief that so many people with depression are sometimes resistant to […]
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GinaMarie Guarino, LMHC
After learning what cognitive behavioral therapy (CBT) is, how it works, and how components like cognitive distortions, automatic negative thoughts, emotions and behavior all contribute to our perceptions, it is important to provide the patient with an automatic thought record (ATR) assignment. An ATR pulls in all of the material to teach the patient how […]
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GinaMarie Guarino, LMHC
Cognitive distortions, or Automatic Negative Thoughts (ANTs) are important for patients to understand when they are learning to challenge their thoughts and behavior. ANTs are patterns in thinking that typically make someone think in the negative and have negative expectations. This can be detrimental to the patient for many reasons, the biggest being it holds […]
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GinaMarie Guarino, LMHC
A huge part of cognitive behavioral therapy (CBT) is understanding what core beliefs are and how they affect people. Core beliefs are the perceived conclusions a person makes about themselves, their world, and their future based on what they have learned through life experiences. When a person develops negative, irrational, or maladaptive core beliefs, the […]
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GinaMarie Guarino, LMHC
Arguably the most popular and useful therapeutic exercise for cognitive behavioral therapy (CBT) is the automatic thought record (ATR). ATRs are so useful because they help the patient take a look at himself and reflect on his own reactions to a given situation. This empowers the patient to reflect and identify his own errors and […]
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GinaMarie Guarino, LMHC
Anxiety may feel as though it is happening for no reason sometimes, but there is always a trigger that generates the symptoms of anxiety. It is important for patients to be able to identify those triggers because when we are able to identify and understand the triggers we experience, we know where we need to […]
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GinaMarie Guarino, LMHC
It is important for a patient to understand what anxiety is and how it affects their life. Often people do not fully understand what anxiety is or how it affects them. Sometimes people do not even realize that they have anxiety until they speak about their symptoms with a professional. That’s why it is important […]
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