TRAILS 7-Session CBT Skills Manual:
Supporting student mental health during
COVID-19
Elizabeth Koschmann, PhD
Emily Bilek, PhD
Welcome!
• Elizabeth Koschmann, PhD
TRAILS Program Director
• Emily Bilek, PhD
TRAILS Clinical Supervisor
Gratitude
The Ethel and James Flinn Foundation Michigan Department of Health and Human Services
Michigan Health Endowment Fund Michigan Department of Education
Blue Cross Blue Shield of Michigan Foundation The University of Michigan Department of Psychiatry and
Comprehensive Depression Center
Metro Health Foundation
The Prosper Road Foundation
Children’s Hospital of Michigan Foundation
The Mackey Family
Community Foundation for Southeast Michigan
The Ouida Family
Detroit Medical Center Foundation
The American Psychological Foundation
The Jewish Fund
“We are not used to this kind of
collective grief in the air.”
Interview with David Kessler, NYTimes March 23, 2020
What is “normal”?
Each person will react differently.
The goal is to help young people develop awareness of
how they are coping and build a toolkit of ways to cope
that are safe and productive.
www.TRAILStoWellness.org
TRAILS provides training and resources that help school
professionals offer evidence-based services to their
students impacted by mental illness.
TRAILS activities during COVID-19
• Survey of school professionals to identify needs, priorities, challenges
• Resources for staff, students, and community members at:
TRAILStoWellness.org/materials/resources/covid-19-resources
• 20-session Social Emotional Learning Curriculum for all students
• 2-hour training for school staff on curriculum and delivery with students
• 1-hour self-care training for school professionals (date TBD)
• 7-session manual for supporting student mental health
• 2-hour training on manual and delivery with students
Training goals
• Introduce the new TRAILS 7-session curriculum for grades 6-12
• Familiarize attendees with each session agenda & supporting materials
• Present available options for post-training support
• Identify strategies to enable student assessment to inform next steps
• Answer any questions
• Wrap up in (under) 2 hours!
Virtual CBT Skills Group for COVID-19 materials
on our website: Grades 6-12
www.TRAILStoWellness.org
7 Sessions in 5 weeks:
• 30-45 minute sessions for grades 6-12
• May be delivered up to 3 times per week
• Designed for group or individual format
• All sessions map on to the resource:
TRAILS Self-Care During COVID-19: For Teens
Evidence-Based Theoretical Framework
Cognitive Behavioral Therapy Mindfulness
Session Materials
Each session has:
• Resources needed
• Introduction
• Homework review
• Activities / Discussion topics
• Highlighted coping skill
• Practice assignment
• Facilitator tips
Goals for Today’s Training
Provide an overview of:
• Each session’s goals
• All associated resources
• Primary session talking points
• Tips and tricks for success
• Overview of practice assignment
Session 1:
How did we get here? How is it going?
Session Goals: Session Resources:
• Connect with classmates • TRAILS Student Self-Care Guide
• Orient students to group • Why I’m Grateful worksheet
• Discuss healthy vs. unhealthy coping • Daily Wellness Journal
• Validate individual experiences
• Introduce skill: Focusing on Gratitude
• Encourage between group practice
Session 1: How did we get here? How is it going?
Primary Talking Points: Tips and Tricks for Success:
• Some coping styles feel good now, but • Consider “rules” that protect privacy on a
cause problems long term virtual platform
• Keep an open mind: new coping styles • Encourage connection during sessions but
may be uncomfortable at first create structure to stay on track
• Practice gratitude: even when things • Help students build internal motivation
are hard, being grateful can help us for trying ‘between session practice”
feel better
Between session practice:
Encourage students to reflect on 3 things they are grateful for each day.
They can record this in their Daily Wellness Journal.
Session 2:
Coping with difficult emotions
Session Goals: Session Resources:
• Validate and normalize the experience • TRAILS Student Self-Care Guide
of conflicting emotions • Check-In Sheet
• Introduce TRAILS Check-In Sheet • Three Relaxation Skills
• Daily Wellness Journal
• Introduce skill: Relaxation
• Encourage between group practice
Optional Resources:
• Additional mindfulness
and relaxation activities
• Distress Tolerance Skills
Session 2: Coping with difficult emotions
Primary Talking Points:
• Emotions are often complex and constantly changing. There are no wrong emotions
• Relaxation can help you manage your emotions by decreasing their intensity and duration
• Relaxation techniques are not one-size-fits-all
• You can treat relaxation practices like mini-experiments: rate your feelings before and after to
see which work best for you
Between session practice:
Encourage students to practice a relaxation skill daily and record it in their Daily Wellness Journal.
Encourage students to continue recording three things they are grateful for.
Session 3:
Managing the voice in your head
Session Goals: Session Resources:
• Normalize that worried thoughts are • TRAILS Student Self-Care Guide
common and happen automatically
• CBT Model
• Explain that worried thoughts can lead to
helpful and unhelpful responses • Daily Wellness Journal
• Introduce skill: Cognitive Coping
• Encourage between group practice
Session 3: Managing the voice in your head
Primary Talking Points: Tips and Tricks for Success:
• We can’t choose our automatic • Some thoughts are true, they just aren’t
thoughts, but we can choose how we helpful. These can still be adjusted!
respond • If students are stuck, ask what they would
• Cognitive coping has 3 steps: identify tell a friend
the automatic thought, examine the
thought, create a coping thought
Between session practice:
Ask students to practice the 3 steps for identifying more helpful “coping thoughts” when worries arise.
Continue practicing other skills as needed/desired.
Session 4:
Using Physical Activity to Feel Better Mentally
Session Goals: Session Resources:
• Review the cycle of inactivity • Self-Care During COVID-19: For Teens
• Discuss how staying active (even 15 • Cycle of Inactivity
minutes daily) is one of the most
• Behavioral Activation Planning
effective skills to improve mood and
stay mentally healthy. • Daily Wellness Journal
• Introduce skill: Behavioral Activation
• Review tips for success
• Encourage between group practice
Session 4: Using Physical Activity to Feel Better Mentally
Primary Talking Points:
• The cycle of inactivity is real: the worse you feel, the less you do
• Physical activity breaks this cycle
• Don’t wait to feel motivated. Rewards and tracking goals can help get you started
• Start where you are and do what you can. This is not a contest with anyone
• Notice your feelings before and after you are active, you will notice it helping
Between session practice:
Follow through on plans to get active and record what they do in their Daily Wellness Journal.
Continue practicing other skills as needed/desired.
Session 5:
Social Connection & Physical Distancing
Session Goals: Session Resources:
• Normalize that many people find it • Self-Care During COVID-19: For Teens
difficult to connect right now • Daily Wellness Journal
• Discuss the benefits of social connection
and ways to connect with others
• Introduce skill: Staying connected
• Encourage between group practice
Session 5: Social Connection During Physical Distancing
Primary Talking Points:
• All students are experiencing social isolation differently
• Social connection is a human need, but will require creativity
Between session practice:
Try 3 ways to stay socially connected and track progress in their journal.
Continue practicing other skills as needed/desired.
Session 6:
Scheduling Time to Take Care of Yourself
Session Goals: Session Resources:
• Discuss with students what the • Self-Care During COVID-19: For Teens
structure of their day looks like • Sticking to a Schedule
• Discuss the benefits of building and • Daily Wellness Journal
sticking to a schedule
Optional Resources:
• Introduce skill: Building a schedule
• Cycle of Inactivity
• Encourage between group practice
Session 6: Scheduling Time to Take Care of Yourself
Primary Talking Points: Tips and Tricks for Success:
• Unstructured time can lead to feeling • Review the cycle of inactivity. The less you
hopeless, overwhelmed, or sad do, the worse you feel à the less you do
• It’s hard to imagine the long-term • The sample schedule may be too detailed
consequences of today’s decisions and overwhelming for some. Help students
• Self-designed schedules help make find the level of detail that would be helpful
days feel less daunting and move you for them
toward your own goals • Students should build their OWN schedules!
Between session practice:
Follow a schedule and notice how it impacts mood, energy, sense of accomplishment.
Continue practicing other skills as needed/desired.
Session 7:
Creating hope through mindfulness
Session Goals: Session Resources:
• Teach students about selective attention • Self-Care During COVID-19: For Teens
to risk, danger, and criticism • Daily Wellness Journal
• Revisit “Coping With Worried Thoughts” • Personal journal or slips of paper
• Introduce skills: Mindful self-compassion
and present focus
Optional Resources:
• Reflect on what was covered during the
7-sessions: what skills did they like, will • Mindfulness for Teens
they use? • Guided Mindfulness Scripts
Session 7: Creating hope through mindfulness
Primary Talking Points: Tips and Tricks for Success:
• Focusing on danger is important when • Consider sending links to meditations
faced with acute threat, but not ahead of time, in case students want to
helpful during a prolonged hardship listen in advance
• Mindful self-compassion takes • Plan time for discussing self-care moving
practice, but can help you manage forward into the summer
difficult times
After session practice:
Plan for the future– building a list of activities they will do when they are able.
Continue practicing other skills as needed/desired.
Virtual support: Effective session facilitation
Safety and logistics Manage group participation
• 2 facilitators if possible • Don’t wait for volunteers (but allow passing)
• Participant phone numbers on hand • Plan for interfering-behaviors
• Disable chat (if possible)
• Closed until the moderator logs in
Confidentiality
• HIPAA compliant platform
• Do not record the sessions
• No photos/screenshots of group
Consider the space
• Minimize distractions (visual/audio)
• Ask participants to wear head phones
• Establish parent/observer boundaries
Next steps:
Getting Started
• Which students will you invite?
• How often will you deliver the sessions?
• How will you manage parent permission
• How will you manage student risk?
• Any measures you’d like students to
take?
• Anxiety / Depression
• Stress related to COVID-19
Ongoing Support from TRAILS
Drop in as needed to our weekly support
calls hosted by Dr. Emily Bilek
• Fridays at 12pm Eastern
https://zoom.us/
Phone: 1-646-558-8656
Meeting ID: 947 1681 3766
Additional support may be available to
TRAILS partners from our clinical expert
Dr. Rochelle Flumenbaum
Post Webinar Email
• Link to survey about today’s webinar
• Link to COVID-19 7-session manual (also at: www.TRAILStoWellness.org)
• Link to today’s slide deck
• CEU certificate info
• Info about post-training support from Drs. Bilek and Fluembaum
• Link to recording of today’s webinar (may need delayed for processing)
Your emotional health matters, too.
Self-Care Training: Free, 1-hour, virtual program
Date: Tuesday, May 26, 2020
Time: 3-4pm
TRAILS Program
