Healthy vs. unhealthy coping skills worksheets

Helping clients to strengthen their coping strategies can be a foundational part of improving mental health. Using a healthy vs. unhealthy coping skills worksheet gives clients a clear framework to evaluate their daily habits.

This article provides an overview of healthy versus unhealthy coping strategies with a list of practical skills and techniques. 

We’ve included free downloadable healthy vs. unhealthy coping skills worksheets to save to your electronic health record (EHR) and use in your practice.

Unhealthy coping strategies

Unhealthy coping strategies may initially ease an uncomfortable feeling or a stressful situation, but ultimately take clients away from facing their problems and reinforce patterns of anxiety and depression. 

Some unhelpful coping strategies include: 

• Drinking or using substances

• Socially isolating

• Avoiding communication or conflict

• Emotional eating

• Self-harm and suicidality

• Self-blame and negative self-talk

• Avoiding responsibilities

• Pushing down your feelings

• Procrastinating

Coping skills questions for adults

When exploring coping strategies with clients, you could ask:

• What do you usually do when you are feeling stressed or overwhelmed?

• How have you coped with difficult situations in the past? 

• What was effective? 

• Which coping strategies were unhelpful?

• Which habits lead you to avoid your feelings or dealing with difficult situations?

• Have any coping strategies made the situation worse? Why?

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Healthy coping strategies

Strategies and techniques to suggest to clients to cope with difficult emotions and relieve stress include: 

• Coping cards: Having a stack of printed coping cards can serve as a helpful reminder of your clients' existing coping abilities and skills. Cards might include positive self-talk or affirmations such as, “This will pass,” “I am safe,” and “This feeling is temporary.”

• Ask for help: Social support is an effective coping strategy. Suggest reaching out to a close friend or supportive family member when having a hard time.

• Distress tolerance skills: Dialectical behavioral therapy (DBT) teaches several distress tolerance skills that provide a practical way to cope with overwhelming emotions, such as ACCEPTS.

• Emotional regulation techniques: There are several strategies you can use to cope with difficult emotions and relieve stress, including exercise, deep breathing, and DBT skills such as Opposite Action and the STOP technique.

• Cognitive restructuring skills: Cognitive behavioral therapy (CBT) provides a supportive framework for understanding and challenging unhelpful thoughts by identifying and reframing cognitive distortions. 

• Maintaining healthy boundaries: While not technically a coping strategy, setting and adhering to healthy boundaries is an act of self-care that protects well-being. 

• Assertive communication techniques: Learning assertive communication skills, such as using “I statements,” can help maintain healthy relationships, set boundaries, and resolve conflicts.

• Grief worksheet: Worksheets, such as tasks of mourning and information on the stages of grief, can help individuals understand, process, and come to terms with a loss.

• Relaxation techniques: Tools like progressive muscle relaxation and body scan exercises can be a helpful way to both release stress and calm the mind before bed.

• Urge surfing: This technique can be used to cope with cravings to use substances. 

• Forgiveness worksheet: Forgiving others can help to release feelings of anger, bitterness, or resentment towards others. 

• Keep a gratitude journal: Practicing gratitude is linked to enhanced physical and mental well-being.

• Behavioral activation: This CBT technique is an effective way to alleviate symptoms of depression through activity scheduling.

• Distraction techniques: Find an activity that distracts the mind from current emotions or feelings, such as playing music, dancing, exercising, taking a hot shower, journaling, or tackling a new project.

How to use the mental health coping skills worksheet 

You can download and use the healthy vs. unhealthy coping skills worksheet in several ways:

• Use the worksheet to provide psychoeducation about healthy versus unhealthy coping skills.

• Complete the worksheet collaboratively in session and give the client a copy to take home.

• Ask clients to reflect on the worksheet, complete the reflection questions between sessions, and report their findings at their next therapy appointment. 

• Use the coping skills questions for adults in group therapy sessions to encourage clients to share more about themselves with other participants.

• Combine this worksheet with other coping skills worksheets, including our distress tolerance skills worksheet, coping skills for depression worksheet, and mindfulness worksheets.

• Share the healthy vs. unhealthy coping skills worksheet with coworkers or leave copies in your office.

• Use this worksheet to provide training to interns or supervisees.

Sources

• Stallman, H. M., Beaudequin, D., Hermens, D. F., & Eisenberg, D. (2021). Modelling the relationship between healthy and unhealthy coping strategies to understand overwhelming distress: A Bayesian network approach. Journal of Affective Disorders Reports.

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