Mind Balance Teen Group

Facilitator Somatic Coaching & Clinical Scenarios

Session 2 Clinical Toolkit

Somatic Script: Paced Breathing & The Physiological Sigh

Guide the group through 3 cycles of physiological sighs:

“When distress spikes above 7 on your thermometer, your nervous system is in fight-or-flight overdrive. Thinking alone cannot calm your body down; we must use your body's biology to send a calming signal back to your brain.”

“We will do a double inhale followed by a long, slow sigh. Inhale deeply through your nose... now top it off with one more sharp inhale through your nose... and now slowly release all the air out through your mouth like you're blowing through a straw...”

“Notice how your heart rate begins to decelerate on the long exhale. Repeat this 3 to 5 times whenever you feel the urge to explode or shut down.”

Crisis Scenarios for Group Role-Play & STOP Practice

Scenario A: The Group Chat Ambush

A peer posts a screenshot of a private conversation in a large group chat. The teen's distress level jumps from 2 to 9 instantly. Have a teen demonstrate applying STOP before sending an angry response.

Scenario B: Academic Panic Lockdown

A student opens an exam, feels overwhelmed, and experiences rapid heartbeat and tears. Walk through applying TIPP (Paced Breathing + Muscle Release) discreetly at a school desk.

Safety Guardrails & Clinical Notes

Cold Water Precautions:

Never use ice water diving reflex for clients with heart conditions, anorexia/eating disorders, or cold sensitivity. Substitute with holding a cool gel pack or hand immersion in cool water.

Distress Tolerance vs. Problem Solving:

Remind teens that distress tolerance skills do not fix the underlying problem; they prevent you from making the crisis worse while your emotion level drops below 6/10.

DBT Adolescent Curriculum • Session 2 Guide Page 2 of 2

Sadness / Depression Isolate in bedroom, stay in bed, shut blinds Get active, go for a walk, text a friend, open curtains.

Fear / Anxiety Avoid presentation, skip social event Approach the situation step-by-step; stay until anxiety peaks & falls.

Facilitator Teaching Script: Acting “All-The-Way”

“Opposite Action only works if you do it all the way. If you go for a walk when you're depressed, but you drag your feet, stare at the ground, and constantly tell yourself how miserable you are—that is half-hearted action, and the sadness will stay stuck.”

“Doing it all-the-way means changing your posture: head up, shoulders relaxed, breathing smoothly, and actively looking at the trees or talking to people. You change the physical input to trick your nervous system into rewiring the emotion.”

Check for Understanding:

“Does Opposite Action mean ignoring or invalidating your feelings?” (No: It means validating the feeling first, and choosing an effective behavior second).

Teen Challenge:

“What is one daily urge you have (like doom-scrolling or staying in bed) that you are willing to test Opposite Action on this week?”

DBT Adolescent Curriculum • Session 3 Guide Page 2 of 2

Group Role-Play Scenarios & Prompts

Role-Play 1: Setting a Boundary with a Peer

A friend constantly demands homework answers or rides last minute. Prompt teen to use DEAR MAN to set a firm, compassionate limit without over-apologizing.

Role-Play 2: Asking a Teacher or Parent for Support

A teen feels completely overloaded and needs an extension or a calm conversation about curfew/stress. Model assertive tone and eye contact (Appear confident).

4-Session Group Debrief & Graduation

Facilitate a closing round where every teen states: 1) The DBT skill they used most over the 4 weeks, and 2) One personal growth milestone they are proud of.

✓ Wise Mind Grounding ✓ STOP / TIPP Survival ✓ Opposite Action ✓ DEAR MAN / FAST

DBT Adolescent Curriculum • Session 4 Guide Page 2 of 2