ACCEPTANCE AND WILLINGNESS EXERCISE:

The Subway Train

Tink of yourself as a subway conductor. Each day you have your route to drive your subway train. As
you guide your train along your route each day, you stop at various stations and pick up passengers.
Each station has its own unique features that become as familiar to you as the rooms in your home. At
each stop, passengers get on and o; some of them are new, some are regulars, some are friendly, some
are nasty, and some are troublesome. As your passengers get on and o your subway train, you keep an
eye on them, paying more attention to some than others, but you realize you cant keep them from getting
on the train. All you can do is observe them and keep an eye out for trouble. Troughout the day, these
dierent types of people get on and o your train. In time, all the passengers get o, and you nish your
route and park the train in the station for the night.
Now think of this subway route as your to- do list for the day. Te activities on your list represent
your goals for the day. Each goal represents something you want or need to do to live a life according to
your values. Instead of people getting on and o the train, imagine your passengers to be the troubling
thoughts, personal scripts, mental images, and painful emotions that are related to the goals you set for
yourself for the day. Te troubling thoughts, personal scripts, mental images, and painful emotions are
related to places you must visit, the people you must interact with, and the tasks you must accomplish.
As you did when you visualized actual people on the subway train, you can step back and observe these
troubling thoughts, personal scripts, mental images, and painful emotions without having to try to control,
avoid, or eliminate them. As with the people on the train, you accept that theyll also come and go, and
you continue to follow your route for the day while living with your passengers. You realize that each day
brings a new dawn, a new route, and a new set of passengers on the journey of your life.
What does this metaphor mean to you?
020
DEFUSION EXERCISE: A New Me
1. Whenever youre stuck in an outdated version of one aspect of your conceptualized self, identify
the actual thoughts, emotions, personal scripts, and mental images that no longer represent
who you are as a person in terms of that segment of yourself.
2. Use a whiteboard, ip chart, or sheet of paper to write down everything your mind tells you
about this outdated aspect of yourself.
Start with your actual thoughts. Say to yourself, My mind is having the following
thoughts about this aspect of myself that no longer represents who I am. Now write down
those thoughts.
Move on to your personal scripts. Say to yourself, My mind has created the following
dialogue about this aspect of myself that no longer represents who I am. Now write down
the dialogue.
Close your eyes and attend to the specic mental images you see with your minds eye.
Say to yourself, I see the following scary pictures regarding this aspect of myself that no
longer represents who I am. Write them all down exactly as you see them.
Last, attend to your emotions and body sensations. Say to yourself, I feel the following
emotions and body sensations regarding this aspect of myself that no longer represents who
I am. Write down these emotions and body sensations.
3. Now step away from the board, chart, or paper, putting at least six feet of distance between it
and your body. Say to yourself, My mind really has a lot to say about this aspect of myself that no
longer represents who I amhow interesting.
4. Do not judge or evaluate what your mind tells you. Instead ask yourself this question: How
helpful is any of this in meeting my goals? Write your answer on a dierent part of the board,
chart, or paper.
5. Ask yourself, What am I willing to accept about what my mind is telling me so I can move forward
to live my life and meet my goals? Write your answer on a dierent part of the board, chart, or
paper.

MINDFULNESS EXERCISE: Checking the Mail
1. To do this exercise, you will need ten large manila envelopes, paper, and something to write
with.
2. Label the ten manila envelopes with the following titles:
Te I can gure it all out in my head trap
Te thoughts are reality trap
Te all thoughts are equally important trap
Te thoughts are orders trap
Te thoughts are threats trap
Te outdated thoughts and personal scripts trap
Te scary pictures are real trap
Te permanence trap
Te pervasiveness trap
Te personalization trap
3. On any given day when you get stuck and cant progress toward the goals you have set for your-
self, start to focus your attention on what your mind is telling you about the situation.
4. Write down on paper the actual words your mind tells you. For example, write, My mind is
telling me I will never learn this new software program, My mind is telling me Im a lousy
lover, or My mind is telling me I cant do anything right.
5. Decide which trap your mind just fell into because of what it told you about the situation, and
put that paper in the proper envelope.
6. Each week, sort out all the envelopes and see which traps you fall into most often. See if you
can categorize the kinds of things and situations that trap you.
Maximize Your Coaching Eectiveness
Client Initial Interview Form
Life Coach: Date:
Name:
Sex: Male Female Age:
Phone: (work) (home) (cell)
E-mail:
Address: City:
State: Zip:
Employer: Occupation:
How long have you worked there? How long in this occupation?
Education: (highest level attained)
How would you prefer to be contacted if I have to reach you in an emergency?
(work phone) yes no (home phone) yes no
(cell phone) yes no (e-mail) yes no
List any major health problems:




List any medications you are taking and for what purpose:





Describe the issue youd like to work with me on:






Have you seen a coach (yes no ) or therapist (yes no ) for help with
your current issue?
If yes, give a brief description of the treatment or help you received:






How were you referred to my practice?

Whom may I thank for referring you?

VALUES-CLARIFICATION EXERCISE: Developing a
Plan for Acting on Your Values
1. Explore what you value. Pick one of the values categories from the Sorting the Mail exercise.
Choose one card from the category to work on. Copy what you wrote on that card on these
lines:




2. Rank this value. Write down the rank you gave the value from the Core vs. Satellite Values
exercise:


3. Publicly arm. Some of the things I can do to arm this value to others are:




4. Take action. Some things I can do to demonstrate this value to others are:




5. Identify the things that make it dicult to arm and act on your values. Te thoughts,
personal scripts, scary pictures, or emotions that make it dicult for me to speak about this value or
act on it are:




6. Identify what you are willing to accept. Im willing to accept the following to arm and act on
this value:




Since this is a complicated exercise, heres an example using Mary, an imaginary client.
1. Explore what you value. I value my work and the adventure it provides.
2. Rank this value. I rank this value the highest I can, at 10.
3. Publicly arm. Tell my family members how much I value them and let them know of my decision
to go to Turkey to be with my future husband. Write my parents a detailed letter explaining how
important this is to me.
4. Take action. Take my mom and dad to Istanbul to meet my anc and see where Ill live and work.
Put my co-op apartment up for sale. Get all of the paperwork nished to apply for a marriage license.
5. Identify what makes it dicult to arm and act on your values.
Toughts: I should please my parents and stay in New York. Good Italian daughters do what
their parents say. Ill be deserting my family if I move to Turkey and marry my anc.
Personal Scripts: I have this image of me boarding the plane, with my parents, grandmother, and
aunt standing in the terminal crying. Im making them all feel bad and I feel very guilty because of
it. I try calling out to them, Please dont cry! Ill be back in six months to visit! but they cant hear
me because of the noise in the terminal.
Scary Pictures: I close my eyes and see myself in Istanbul, alone in my dorm room, missing my
family. I have my annel pajamas with the little feet on and look like a scared little girl.
Emotions: I feel guilty, afraid, worried, and anxious.
6. Identify what you are willing to accept. Feeling guilty and anxious about leaving and being in a
new, strange place. Having my painful thoughts, scripts, and scary pictures roll around in my head
while I take action.
ACCEPTANCE EXERCISE: Embracing Change
1. Tink about a pending change in your life that has left you feeling stuck and unable to progress
toward a goal, or think of a past change that left you stuck.
2. What is about to change, or what changed in the past?
3. What is it about the change that has you stuck, or what was it about the past change that left
you feeling stuck?
4. What troubling thoughts is your mind telling you about this change, or what thoughts did it
tell you in the past?
5. What outdated personal scripts has your mind created about this change and your ability to
handle it, or what did it create about the past change?
6. Whats the scariest picture your mind has created about this change or about the past change?
7. What painful emotions does this change arouse, or what emotions did a past change arouse?
8. On a scale of 1 to 10, how threatening is, or was, this change?
9. How have you dealt with similar changes in the past?
10. What can you do to prepare for this change, or what could you have done to prepare for a past
change?
11. How much time do you have to prepare for this change, or how much time did you have to
prepare for a past change?
12. What are you willing to accept about this change, or what would you have been willing to
accept about a past change?
13. How can you grow by adapting to this change, or how could you have grown by adapting to a
past change?
GOAL-SETTING EXERCISE:
Setting Values-Based Goals and Objectives
1. Pick one of your three most important values categories you identied in the Core vs. Satellite
Values exercise you completed.
2. Pick one value from the category you selected.
3. Describe how this value currently inuences your personal and professional lives.
Personal:



Professional:



4. Write one new personal goal related to this value.
Personal Goal:



5. Write three measurable objectives related to this goal. Remember, measurable objectives answer
the question, Who will do how much or what, by when?
a.


b.


c.


6. Write one new professional goal related to this value.
Professional Goal:




7. Write three measurable objectives related to this goal. Remember, measurable objectives answer
the question, Who will do how much or what, by when?
a.


b.


c.


Following is an example of this exercise using the values and goals of a former client whos a
licensed professional counselor (LPC) and writer.
1. Pick a values category. Te category I chose was work.
2. Pick one value from the category you selected. One of the things I value as part of my work is
writing.
3. Describe how this value currently inuences your personal and professional lives.
Personal: Because I value writing, I often use personal time at night and on weekends to write, so
I can stay on schedule and meet my deadlines. Im usually able to do this without taking time away
from activities and responsibilities I share with my wife.
Professional: Because I value my personal writing above work-related writing tasks, I often fall
behind in my case notes and documentation. My old supervisor accepted this fact and gave me extra
time to catch up on my case notes. My new supervisor has taken an exactly opposite approach and
has threatened to le a complaint if I do not keep my case notes current.
4. Write one personal goal related to this value.
Personal Goal: I will not let my book writing interfere with activities and responsibilities related
to my relationship with my wife.
5. Write three measurable objectives related to this goal.
a. By the end of April, I will start each day by going for a walk with my wife before we leave for
work.
b. By the end of April, I will end each day by spending time talking with my wife instead of
writing.
c. By the end of May, I will go bicycle riding at least twice a week and go to the movies at least once
each week with my wife.
6. Professional Goal: Id like to nish my rst trade paperback book on memory development that I
am currently working on.
7. Write three measurable objectives related to this goal.
a. I will nish the rst draft of the rst half of my new book by the end of August.

b. I will nish the rst draft of the second half of my new book by the end of December.

c. I will submit the nished manuscript to my literary agent by New Years Day.

ACCEPTANCE AND WILLINGNESS EXERCISE: I
Am Willing to Accept
1. Tink about all the unhelpful thoughts, personal scripts, mental images, and emotions your
mind gives you about a goal around which you feel stuck. Now think about all the things youve
tried in the past (psychotherapy, drugs, alcohol, and so on) to control, eliminate, or avoid your
pain and suering, and how ineective these things have been. Instead of trying to control,
eliminate, or avoid the unhelpful thoughts, personal scripts, mental images, and emotions your
mind gives you, try living with them as you take action toward your goal. Complete the follow-
ing statements.
2. I am stuck regarding the following goal:


3. My mind is giving me the following unhelpful thoughts and personal scripts about this goal:






4. My mind is creating the following unhelpful mental images about this goal:






5. My mind is creating the following unhelpful emotions about this goal:






6. Trying to control, eliminate, or avoid these unhelpful thoughts, personal scripts, mental images, and
emotions has resulted in the following consequences:






7. I am willing to accept and live with the following unhelpful thoughts, personal scripts, mental images,
and emotions as I take action toward my goal:






WILLINGNESS EXERCISE:
I d Better Use My Umbrella
1. Te next time you feel stuck and unable to move toward a goal because you cant cope with your
troubling thoughts, outdated personal scripts, scary pictures, and painful emotions, identify the
exact messages youre telling yourself about the situation.
2. Next, close your eyes and visualize the sky darkening, the wind picking up, and rain clouds
swirling all around you. Now imagine that the messages your mind is telling you and any other
painful thoughts you have about the situation are raindrops just beginning to fall on your head.
You feel the drops and say to yourself, Id better use my umbrella.
3. Imagine you have an umbrella. You open it and feel instant relief from your troubling thoughts,
outdated personal scripts, scary pictures, and painful emotions. Like raindrops, they bounce
o your umbrella and dont interfere with your doing what you need to do. As you continue
walking in the rain with your umbrella, tell yourself, Just as I can use an umbrella to help me
manage experiencing real rain, I can use my acceptance and willingness umbrella to help me live my
life while experiencing unhelpful thoughts and feelings.
4. Anytime you see the storm clouds of your troubling thoughts, outdated personal scripts, scary
pictures, and painful emotions on the horizon, tell yourself, Id better get my umbrella, and begin
to view them as raindrops bouncing o your umbrella as you go about doing what needs to be
done.
MINDFULNESS EXERCISE: Mindful Lawn Mowing
1. Pick a time to mow your lawn when you have nothing else to do. Give yourself a minimum of
thirty minutes as a cushion of time between the end of your lawn mowing and your next activ-
ity. Te idea is to be able to mow without rushing.
2. Tell your family members you will be mowing the lawn and dont want to be disturbed for the
next thirty minutes. Tey must fend for themselves during that time.
3. Pay attention to every step of the lawn-mowing process, no matter how trivial it may seem
initially.
4. As you check the oil and gas levels of the lawn mower, pay attention to the color, smell, and
viscosity of the gas and oil. Note the sound the gas makes as it sloshes in the tank or splashes
from the lling can into the tank. Feel the tension in your hand and ngers as you tighten the
gas cap.
5. Before you cut, look at your grass from a couple of dierent angles and perspectives. Observe
it while standing, sitting, kneeling, and even lying on your side. Get a sense of its depth and
texture.
6. As you cut, slow the speed if you have a self-propelled mower, so you can move with the mower
rather than have it propel you along. If your mower is a push mower, walk at a comfortable
pace, not too fast, not too slow.
7. Synchronize your breathing to the number of steps it takes you to breathe fully but comfort-
ably. For example, you can take six steps to inhale and six steps to exhale if you are walking at
a moderate pace.
8. Tell yourself as you start to mow, Tis is my time to mow the lawn. I have nowhere else to go and
nothing else to do during the next thirty minutes except care for this beautiful, green lawn.
9. As you continue to mow, count your paces to yourself. Saying, One, two, three, will help you focus
your self-talk on the present moment and keep your mind from drifting to the past or future.
When your mind wanders, as it will, tell yourself, My mind is telling me .
Tis is okay, but I will now redirect my focus to my counting.
10. As you mow the lawn, pay attention to the pattern of your cut. Admire the even lines and the
changing height of the lawn as your mower passes over it. Keep your visual attention on the
lawn, and when you get distracted by passing cars, waving neighbors, or other visual distrac-
tions, come back to the lawn.
11. Continue mowing in the present moment until the lawn is nished. Have a forgiving mind-
set and always come back to your counting (self-talk) and lawn (mental image) when you get
distracted.
12. When you are nished mowing, give the after-mowing work your full attention. Clean up and
put your mower away with the same focus and attention you directed toward the mowing.
13. Take a few moments to admire your cut lawn. Sit or lie down on it and appreciate the sight,
smell, and feel of it.
14. While this may seem a bit extreme to you now, after a few practice runs, you will begin to
appreciate the beauty of something as simple as mowing your lawn.
MINDFULNESS EXERCISE: Just Sitting
1. For the next ve minutes, sit quietly in a straight-backed chair, with your feet at on the oor,
eyes closed, back straight, and your hands folded gently in your lap.
2. Be mindful of what of feels like to be stuck, starting with your breathing. Follow the course of
your breathing from the inspiration of air into your nose all the way down to your lungs and
then out again. What does this feel like?
3. Next, note any other body sensations. Whats going on in your arms, legs, chest, back, and
other parts of your body?
4. Now be mindful of your thoughts and emotions. What are you thinking and feeling?
5. Dont judge your sensations, thoughts, and feelings; merely note their presence.
6. Try to keep your focus on the present moment. When your mind drifts into the future or past,
gently remind yourself to return to the present, using phrases like Tere goes my mind drifting
o again. Its okay, but now Im going to get back to the present moment and whats going on in my
mind and body.
7. When your ve minutes are up, take a few minutes to write down what went on in your body
and mind.
8. Bring these notes with you when you come back for our next session, and well talk about the
next step, accepting whats going on within in you as you take action.
MINDFULNESS EXERCISE:
Mindfulness Meditation
1. Sit on the oor, on a cushion, or in a straight-backed chair.
2. Sit with your head up and your back straight. Imagine that your head is oating gently on your
neck and spine.
3. Take a few slow, deep breaths.
4. Pay attention to the thoughts, sensations, and feelings that come over you. Go with them wher-
ever they take youdo not ght them.
5. Try to endure uncomfortable physical experiences (an itch, pain, the urge to move, and so
on) for a while to see where this takes you. Sometimes youll notice that these responses (like
thoughts and emotions) will pass if you let them play themselves out. If you have to move, do
so slowly and intentionally.
6. Continue to sit for ve minutes, noting what youre experiencing in an accepting, nonjudgmen-
tal way. If you catch yourself drifting to the past or future, tell yourself, My mind is taking me
out of the here and now and into (describe where its taking you).
7. If you nd yourself evaluating or judging something, tell yourself, My mind is judging or evaluat-
ing again instead of merely noting (whatever its judging or evaluating).
8. As you notice things, you can label them. You can say to yourself, I am having the feeling
that , or I am having the thought . You can use this
self-talk to categorize anything you experience.

WILLINGNESS EXERCISE: The MP3 Player
Give these instructions to your clients:
1. Imagine you are going out for a run. You are all ready to go, so you put your portable MP3
player in your arm holder and insert your earbuds, and youre ready to rock and roll.
2. Tis compact player has two earbud speakers, selection and volume controls, and a button with
an up-and-down arrow to regulate the bass and treble functions. When you want to increase
the treble, you press and hold the up arrow and the treble increases. When you want to increase
the bass, you press and hold the down arrow, and the bass increases. Tese functions work in
opposition to each other. As you increase the treble, the bass decreases and vice versa.
3. Now imagine that instead of the up-and-down arrow regulating the treble and bass, it regulates
willingness and control. Te up arrow regulates willingness and the down one regulates control.
4. Te next time you have an unhelpful thought, personal script, mental image, or emotion youre
trying to control or eliminate, imagine that youre hooked up to your MP3 player and have your
thumb on this up-and-down arrow.
5. Press and hold the down arrow (the control function) and notice how you increase your desire
to control, avoid, or eliminate your unhelpful thoughts, scripts, mental images, and emotions.
As you continue to press and hold the down arrow, you are less and less willing to take valued
action.
6. Now press and hold the up arrow (the willingness function), and notice how this begins to
reverse. As your willingness increases, you begin to accept your discomfort and become more
and more willing to take actions while living with your unhelpful thoughts, personal scripts,
mental images, and emotions. Notice how your need to control your pain and suering decreases
as your acceptance and willingness to take valued action despite it increases. (Adapted from
Te Willingness Scale, Hayes, 2005.)
DEFUSION EXERCISE: My Photo Lineup
1. Cut up twenty pieces of rm poster board to 8 inches by 10 inches.
2. Make ve piles of the poster board (four pieces in each pile).
3. Label the ve piles and individual pieces according to the following ve stages of your life:
infancy, early childhood, teen years, early adulthood, adulthood.
4. For each stage of your life, gather four photographs of yourself. Make sure to include photos
that bring back both pleasant and painful memories.
5. Mount each photo on a piece of poster board, leaving enough room under the photo to write
a couple of sentences.
6. Under each photo, write the approximate date of the photo and the personal script you associ-
ate with it. Make sure you have two positive and two negative scripts.
7. Now take one pile and line up the four photos, preferably at eye level on a shelf, and step away
from them. Keep stepping back until you achieve a comfortable distance between yourself and
these images.
8. Go through the four pictures and describe the things about you displayed in each photo that
still hold true (you like to cuddle, you still play softball, youre still no good at math, and so on).
Actually write these things on the poster boards.
9. For each item, describe the things about you displayed in the photo that are no longer true.
10. Go through each pile and each photo, repeating steps 8 and 9.
11. Which of the thoughts or beliefs still contribute to your being stuck?
12. Take any individual photo containing an outdated description of you and say the following:
Tis no longer represents who I am. Im not going to let it keep me stuck or let it stand in the way
of meeting my goals.
13. Take the photos that represent beliefs that contribute to your being stuck and put them in an
envelope.
14. Put the envelope up high on a bookshelf, where you cant see it but still know its there.
15. Say to yourself, I know those photos and unhelpful thoughts are part of me, but I can tuck them away
for the time being and move toward my goals. While these are part of me, Im much more than the
sum total of these outdated photos and stories from the past.
VALUES-CLARIFICATION EXERCISE:
A Perfect Day
If you could plan a perfect day, what would it include? What specic activities would you be
involved in? Where would you be? Whom would you be with? Would you be living on an island,
in a new city or country, or right where you are now? Would you be in a new job or even working
at all? Would you be with a new partner or your current one? Let your imagination run free, but
be as specic as possible. Instead of saying something like relaxing, say, lying by a pool with my
partner or meditating under a tree.
List up to ten daily life criteria for a perfect day:










How do these daily life criteria reect your core and satellite values?
How does your typical day compare to this perfect day?
What stands in the way of your meeting your daily life criteria for the perfect day?
021
DEFUSION EXERCISE: Rethinking Permanence
1. Whenever you fall into the permanence trap, identify the actual thoughts, emotions, per-
sonal scripts, and mental images related to your feeling that whatever issue you are stuck in is
permanent.
2. Say to yourself, My mind is telling me the following things about the permanence of this condition,
then, using a whiteboard, ip chart, or sheet of paper, write down everything your mind tells
you about this outdated aspect of yourself.
Start with your actual thoughts. Say to yourself, My mind is having the following thoughts
about the permanence of this condition. Now write down those thoughts.
Move on to your personal scripts. Say to yourself, My mind has created the following
dialogue about the permanence of this condition. Now write down the dialogue.
Close your eyes and attend to the specic mental images you see. Say to yourself, I
see the following scary pictures regarding the permanence of this condition. Write them all
down exactly as you see them.
Last, attend to your emotions and body sensations. Say to yourself, I feel the following
emotions and body sensations regarding the permanence of this condition. Write down these
emotions and body sensations.
3. Now step away from the board, chart, or paper, putting at least six feet of distance between
it and your body. Say to yourself, My mind really has a lot to say about the permanence of this
conditionhow interesting.
4. Do not judge or evaluate what your mind tells you. Instead ask yourself this question: How
helpful is any of this in meeting my goals? Write your answer on a dierent part of the board,
chart, or paper.
5. Ask yourself, What am I willing to accept about what my mind is telling me, so I can move forward
with living my life and meeting my goals? Write your answer on a dierent part of the board,
chart, or paper.
Heres an example of this exercise using a client named Christos and his problem.
1. My mind is having the following thoughts about the permanence of this condition: Ill never
come back if I leave. My family will never welcome me back if I leave.
2. My mind has created the following dialogue about the permanence of this condition:
Chris, once you leave home, theres no coming home because youll just forget about your family and
friends (Dad speaking to me).
My dad will never welcome me back if I move out of the house and go to school in a dierent part
of the country.
3. I see the following scary pictures regarding the permanence of this condition:
I see me standing on the Golden Gate Bridge with a sad look on my face, carrying my suitcase and
textbooks.
I see myself returning from graduate school and going back home. Im standing there trying to get
the key to work, when I realize my parents have changed the locks.
I see myself out on the street in front of my parents house, looking up at my old bedroom window,
with my suitcase, laptop, and textbooks at my feet.
4. I feel the following emotions and body sensations about the permanence of this condition: Im
so sad that I start crying. Im afraid. I feel my chest tighten, and my eyes start to well up with tears.
5. I step back from what Ive written down and say out loud, My mind really has a lot to say about
the permanence of this conditionhow interesting.
6. My answers to the question How helpful is any of this in meeting my goals? are:
Not helpful at all.
Tey keep me stuck.
Tey do nothing to resolve the problem.
7. I am willing to accept the following, so I can move forward with living my life and meeting my
goals:
Im willing to accept my troubling thoughts and personal scripts.
Im willing to accept my scary mental images and painful emotions.
Im willing to accept the idea that I dont have to control, avoid, or eliminate these things my mind
tells me before I start moving toward my goal of going to graduate school wherever I get the best
oer.
Sample Informed Consent Form
Following is a sample form using my personal coaching information as an example. You must deter-
mine what and how much information about your background you wish to include. Clients must
be given enough information to be able to make an informed choice regarding whether or not you
seem like a good t for them.
INFORMED CONSENT
Background and Approach to Coaching:
Tank you for choosing me, Dr. Richard Blonna, as your coach. I realize that working with me
is a major decision, and you may have many questions. Tis document is intended to inform you of
my policies, state and federal laws, and your rights. If you have other questions or concerns, please
ask and I will try my best to provide all the information you need. I have a bachelor of science in
psychology from William Paterson University, a masters degree in education (specialization in
counseling and special services) from Seton Hall University, and a doctoral degree in health educa-
tion (specialization in health counseling) from Temple University.
I am a certied professional coach (CPC), national certied counselor (NCC), and certied
health education specialist (CHES) with over twenty-ve years of experience in teaching and
coaching adults using individual and group methods. My work is limited to coaching adults in the
following areas: life coaching, stress management, and writers block.
My eclectic background and training has enabled me to develop an approach to coaching that
incorporates principles and practices drawn from coaching, health education, acceptance and com-
mitment therapy (ACT), naikan self-reection, and classic relaxation training (diaphragmatic
breathing, meditation, visualization, and so on). I combine all of these methods in an eort to help
you get unstuck, stay motivated, and meet your goals. While my approach uses some techniques
drawn from ACT, I am not a therapist and I am not trying to practice psychotherapy using these
techniques. Many dierent therapeutic techniques can be adapted for coaches and coaching clients.
Nature of My Distance-Coaching Practice:
Prior to beginning coaching, you will have a free consultation with me by telephone to assess
your needs and discuss my approach, so you can make an informed decision regarding working
with me. During this consultation I will explain how we will work together, discussing condenti-
ality, your rights as a client, and other nuances of working at a distance.
If you agree to work with me, you will then ll out and return (by fax or regular mail) some
basic forms (informed consent, client data, and so on). Additionally, you will be required to pur-
chase my two self-help books and relaxation CD ($16.99 each) before beginning our work together.
I use a lot of directed readings and skill-building exercises contained in the books and relaxation
CD, so youll need them to work with me.
After sending the forms and purchasing the books and CD, you can purchase your rst online
session. When you purchase an online session, I am automatically notied by e-mail. At this point
I will send you an e-mail to schedule our rst session together.
Structure of Coaching Sessions:
During our sessions together, you will be a very active participant in the coaching process. In
addition to talking with me, you will be given reading assignments and be asked to practice tech-
niques from the books and relaxation CD. Your commitment to doing this work outside our live
distance sessions is crucial to your success. I expect that you will do all of the reading and exercises
prior to our live sessions together.
Each session is divided into two parts: a live session where we communicate by telephone,
webcam, or both and an asynchronous session where we communicate by e-mail. During the asyn-
chronous session, you submit your assignments (ongoing journals, completed exercises, and so on)
using e-mail attachments or fax, and I will review your work prior to our live session. Tis will help
me structure our live session and provide feedback regarding your progress. For our live sessions
to be eective, I must receive your work prior to your appointment so I can review it in advance.
Please indicate how you prefer to send and receive those assignments and information.
I prefer to send and receive information and assignments by e-mail __ fax __ both __.
Signature Date
Financial Agreement:
Te fee per session is $150.00. You may pay for sessions using your credit or debit
card or PayPal account. You can sign up for a session by visiting my website: healthystress
doctor.com/signup.html. If you prefer to pay by check, you can send it to:
Dr. Richard Blonna
50 Wallace Blvd.
Hillsborough, NJ 08844
All checks must be received in advance of your appointment.
If you need to cancel or reschedule an appointment, please notify me at least twenty-four hours
in advance; otherwise you will be billed for the missed session.
Signature Date
Insurance Issues:
I do not accept third-party reimbursement from health insurance carriers. I do not accept
assignment of benets, nor do I participate in managed care insurance plans (HMOs and PPOs).
If you have insurance that provides coverage for my services, I will gladly discuss the coaching ser-
vices you receive from me if your insurance company calls me and you provide me with a release
granting me the right to talk with them. I do not call to request authorizations. You are responsible
for contacting your carrier, securing necessary forms, lling them out, and sending them back at
your expense.
You are responsible for paying for all coaching services in full prior to submitting any insurance
claims.
Signature Date
Coordination of Care:
It is important that all health care providers work together. As such, if you would like me to
share information about your coaching sessions, I will need your permission to communicate with
your primary care physician, therapist, or both. In the event that you grant me this permission,
please be advised that I will not initiate contact with them. Tey must request information directly
from me. Your consent is valid for one year. Please understand that you have the right to revoke this
authorization, in writing, at any time by sending notice.
If you prefer to decline consent, no information will be shared.
You may inform my physician, counselor, and so on.
You may not inform my physician, counselor, and so on.
Physician name:
Address:
Telephone:
E-mail:
Terapist name:
Address:
Telephone:
E-mail:
Signature Date
Confidentiality and Emergency Situations:
Your verbal communication and coaching records are strictly condential except for (1) infor-
mation shared with your insurance company to process your claims (if my services are covered by
your insurance), (2) information you report to me about physical or sexual abuse (I am obligated to
report this to the Division of Youth and Family Services), (3) when you sign a release of informa-
tion to have specic information shared with your physician or therapist, and (4) when you provide
information that informs me that you are in danger of harming yourself or others.
If an emergency situation occurs for which you feel immediate attention is necessary, you
understand that you are to contact the emergency services in your community (911). I will follow
up those emergency services with coaching service and support.
Signature Date
MINDFULNESS EXERCISE: The Sensuous Orange
Youll need to purchase an orange for this exercise. Navel oranges work best since they are the
easiest to peel. Youll want to put your orange on some paper towels to absorb any orange juice and
oil thats released during the exercise.
Pick a time when you can devote twenty minutes to this exercise and have nothing else to do.
Its preferable to do this exercise when no ones around to disturb you. You might nd it easier to
record the instructions and then play them back and follow them, which will allow you to focus
fully on what you are doing without having to read or turn pages.
1. As you work through this exercise and get distracted, tell yourself, Its okay. My mind is telling
me . I will now refocus my attention on my orange. Tis is my time to practice
mindfulness.
2. Take your orange and examine it visually. Without judging your orange, note its color (not all
oranges are perfectly orange), shape, size, and texture.
3. Like humans, oranges have distinguishing characteristics. What distinguishing characteristics
does your orange have? Does it have a scar, a dimple, or any other irregularity that sets it apart
from other oranges?
4. Now shift your attention to the sensation of touch. Close your eyes and feel the orange. Feel it
with your ngertips. Ten roll it around in your hands and notice its weight. What does your
orange feel like? Is it smooth, rough, bumpy? Is it cool, hot, warm?
5. With your eyes still closed, roll the orange around your face, over your cheeks, eyes, nose, and
down your neck. What does it feel like on your face?
6. Open your eyes and slowly peel the orange. Your goal is to take the entire peel o in one piece.
Take your time; you have nowhere to go and nothing to do but practice your mindfulness on
your orange.
7. Now shift your attention to the smell of the orange. Close your eyes and smell the unpeeled
fruit. What does it smell like?
8. Break o a two-inch piece of the peel and twist it until the orange oil is released. What does
that smell like? Is it the same as the unpeeled fruit, or is it more pungent?
9. Now close your eyes again and shift your attention to the taste of the orange. First taste the
orange oil. Describe what the oil tastes like.
10. Open your eyes and taste a small piece of the peel. What does it taste like?
Maximize Your Coaching Eectiveness
11. Carefully separate the orange into sections. Take one section and gently open it, peeling back
the delicate membrane that holds the section together. Peel away the membrane and hold it
against the light. What do you see?
12. Take one small piece of orange pulp out and look at it. What does it look like? Now place that
piece of pulp in your mouth and burst it with your tongue on the roof of your mouth. What
does it taste like?
13. With your eyes closed, take a bite of the section of orange. Chew it at least fteen times slowly.
Focus rst on the sound of your chewing. What does it sound like to chew the orange?
14. Continue eating the remainder of the orange section. What does your orange taste like? How
does the fruit dier in taste from the peel and the oil?
15. Now slowly nish eating the entire orange, section by section, with your eyes closed.
16. Focus all of your attention on the taste and smell of the orange. If you get distracted by other
mental images, come back to the mental picture of what your orange looked like. If you get
distracted by unrelated self-talk, tell yourself, My mind is telling me . Tats
okay. My orange tastes and smells like . Keep returning to your thoughts and
self-talk about your orange.
17. When you are nished, spend a few moments thinking about your orange and the sensory
delights it just provided you.
VALUES-CLARIFICATION EXERCISE:
Sorting the Mail
Plan to spend thirty minutes on each part of this exercise. You will probably have to spend more
than one session to work through all of your values. You can set up the exercise two dierent ways:
buy a ten-slot organizer from your local oce-supply store, or make one using ten manila folders
fastened securely to poster board or a piece of wood. In either case, label the slots or ten manila
folders with these ten titles:
Intimate Relationships
Family Relationships
Friendships and Other Relationships
Health
Spirituality
Finances
Learning
Work
Te Environment
Civic Duties
On 5-inch by 8-inch le cards, answer the following values questions for each category: What
exactly do I value about ? Fill in the category. You can have more than one
value for each category. Example: What exactly do I value about intimate relationships?
I value having someone who shares my love.
I value having a single sexual partner.
I value having someone with whom I can share my deepest thoughts and feelings.
I value having a close companion to share each day with.
DEFUSION EXERCISE:
Take Off Those Asthma-Colored Glasses
1. Imagine that you have a pair of really dark sunglasses that you use when its very sunny outside.
Tese sunglasses are so dark that when you come indoors and forget to take them o, its really
hard to see.
2. Now imagine actually doing that: putting on your dark sunglasses; walking around outside on
a bright, sunny day for a while; and then coming in and forgetting to take them o.
3. Imagine what it would actually be like to walk around indoors with these dark sunglasses on,
with your vision limited. Not only would you be restricted in what you could see, but youd
also be restricted in what you could do. It would be very dicult to take action on something
simple that you value, like being able to prepare your breakfast or do your laundry.
4. Imagine how easy it would be to x this problem by simply taking o your dark sunglasses.
5. Now shift gears and imagine that you have asthma (or some other chronic condition that
impacts your health on an ongoing basis).
6. Imagine that these same dark sunglasses represent your self-as-content view and say to yourself,
Im an asthmatic or Im a diabetic, or use some other chronic health condition.
7. Now imagine that your view of yourself as an asthmatic or a diabetic is standing in the way of
your taking action on something you value (such as exercise, travel, or dancing).
8. As soon as that happens, put on those asthma-tinted sunglasses and say to yourself, Tere I go
again, putting on my asthma-colored glasses.
9. Imagine walking around in the dark with your asthma-colored glasses on for a few moments,
thinking about how limiting they are and how they are keeping you stuck.
10. After a few moments, stop and say to yourself, I dont have to wear these glasses. I can just take
them o whenever I want to. Ten imagine that you just take o the glasses, fold them up, and
put them away in your pocket. Along with the glasses, imagine putting away the thought, Im
an asthmatic.
11. Last, imagine taking the action you planned while keeping your asthma-colored glasses and
unhelpful words in your pocket. You can live with them and take action without trying to get
rid of them.
12. Practice this simple defusion exercise whenever youre stuck in any stereotypical personal script
based on a self-as-content viewpoint. In time you can learn how to defuse from the self-limiting
thoughts associated with the stereotype.
ACCEPTANCE AND DEFUSION EXERCISE: Train
Watching
1. Te next time you feel yourself getting swept along by your unhelpful thoughts, personal scripts,
mental images, and emotions, imagine that they represent a one-hundred-car freight train bar-
reling down the railroad tracks at maximum speed.
2. Loaded down with the freight and baggage that make up your mind, the cars are labeled
troubling thoughts, unhelpful and outdated personal scripts, scary pictures, and painful
emotions.
3. Imagine that you see the train on the horizon and race toward the railroad crossing to try to
beat the train so you can get home from work on time.
4. As you near the crossing, the lights start ashing, bells start clanging, and a barrier descends,
warning you of the approaching train and imminent danger. You can still outrun the train and
cross the tracks before the barrier completely descends, but you slow down and stop before
getting to the tracks. Te barrier descends, leaving you stuck so that you cant meet your goal
of getting home at the designated hour.
5. As you sit there, your mind starts analyzing why you got stuck and what things you could have
done to avoid arriving at the railroad crossing at the same time as the train. Your mind says you
could have left your meeting at work earlier, driven faster on the ride home, averted a couple
of trac lights that held you up, and so on. Your mind also starts racing ahead, for example
rehearsing the argument you assume you will have with your wife because of your lateness for
dinner. Shell say, You never get home on time when Im preparing a nice dinner. You never
take my feelings into consideration. You know I like to serve the food hot, right out of the oven.
You are so inconsiderate. Your son chimes in, You know that I have a game tonight, Dad,
and that you and Mom need to drive me. Do you want me to be late and have the coach get
all pissed o? You never think of anyone except yourself. You try to eliminate these thoughts,
images, and feelings, and work on getting them out of your head, but the more you think about
them, the more vivid they become.
6. Now shift gears and imagine that the railroad crossing is a protective barrier that provides a
safe way for you to stop and pay attention to whats going on in your mind and life. You stop,
take notice, and feel protected by the distance your minds own personal railroad crossing estab-
lishes between you and your troubling thoughts, unhelpful scripts, scary pictures, and painful
emotions.
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7. Instead of trying to avoid the train by outrunning it, your decision to stop and observe it creates
some helpful space between you and your runaway-train brain. Instead of analyzing and judging
what your mind tells you about being late for dinner, imagine that each dierently painted
railroad car represents a painful thought, unhelpful personal script, scary picture, or painful
emotion thats ying by and trying to sweep you along with it.
8. Protected by the distance of your minds railroad crossing, you begin to accept your thoughts
and feelings as temporary, as eeting as the cars that make up the train. As you continue to
watch your train roar by, you accept that you cannot control this powerful force. You tell your-
self that the train will soon pass, the blinking lights and clanging bells going o in your mind
will cease, and your personal barrier will rise, allowing you to continue on home to your family
and dinner.
VALUES RANKING AND DEFUSION EXERCISE:
Core vs. Satellite Values
1. Look at the ten envelopes or the organizer you set up in the previous exercise.
Rank each envelope or slot in the order of importance (1 = the highest).
2. If youre using envelopes, put the three most important envelopes in a pile and scatter the
remaining seven around the ones in the middle (somewhat like the way electrons circle the
nucleus of an atom).
3. Pull out all of the value cards from the three most important envelopes or slots and put them
into a pile.
4. Read each value a few times.
5. Rank each of the values contained in this pile from most important to least important.
6. Line up all of these cards in order of their importance.
7. Step back three feet from these cards and tell yourself: Tese are my most deeply held values, and
I accept them for what they are. While they are important to me, I am more than these values. Tey
are part of who I am and I carry them with me always, but they dont have to control the actions I
know I need to take to realize my dreams.
8. Step back another three feet, distancing yourself a little more from the cards. Give yourself a
little more breathing room to create some more space between you and the things you value.
DEFUSION EXERCISE: The Values Whiteboard
1. Whenever youre stuck in a values conict, identify the underlying value as clearly as possible.
Use a whiteboard, ip chart, or sheet of paper to write on. Say to yourself, My mind is telling
me the following things about this values conict, then write down everything your mind tells you
about this conict. Make sure to include both individual words and personal scripts regarding
the values conict.
Say to yourself, I see the following scary pictures regarding this values conict, then close
your eyes and attend to the exact mental images you see in your minds eye. Write
them all down exactly as you see them.
Say to yourself, I feel the following emotions and body sensations regarding this values con-
ict, then write down these emotions and body sensations.
2. Now step away from the board, chart, or paper, putting at least six feet of distance between
it and your body. Say to yourself, My mind really has a lot to say about this values conicthow
interesting.
3. Do not judge or evaluate what your mind tells you. Instead ask yourself this question: How
helpful is any of this in managing my stress and meeting my goals? Write your answer on a dier-
ent part of the board, chart, or paper.
4. Ask yourself, What am I willing to accept about this conict to move forward so I can live my life
and meet my goals? Write your answer on a dierent part of the board, chart, or paper.
VALUES-CLARIFICATION EXERCISE:
What Are You Willing to Die For?
Te following statements are designed to help you examine the strength of your values. Tere are
no right or wrong responses. Tey are designed to help you gain insight into whats truly important
in your life. Complete these statements:
1. I would be willing to die for .
2. I would be willing to ght for .
3. I would be willing to strongly argue in public (in a group or society) for .
4. I would be willing to strongly argue in private (with friends or family) for .
5. I would be willing to publicly support .
6. I would be willing to privately support .
7. I prefer to keep the following values to myself: .
Tere are no right or wrong answers when it comes to values. By understanding the strength of your
values, you can see how they relate to the thoughts, personal scripts, mental images, and emotions you
have about them.
DEFUSION EXERCISE: The Whiteboard
To do this exercise you will need either a whiteboard with markers and an eraser, or a large pad
with colored markers.
1. Te next time you get hooked by one of the thinking traps and are stuck, get out your white-
board or large pad and markers.
2. Pick up one of the markers and write this heading: Unhelpful Toughts My Mind Is Telling
Me About (whatever youre stuck about). Example: Unhelpful Toughts
My Mind Is Telling Me About Starting My Own Graphic Design Business .
3. List all of the thoughts your mind is telling you about being stuck. Examples:
I cant do this.
My dad was right. Im not a businesswoman.
I should have gone into nance.
Ill never be able to learn everything I need to start my own graphic-design business.
Id be better o continuing to work for someone else.
Having your own business is not such a big deal.
4. Be sure to list all of your thoughts, no matter how crazy, silly, or inconsequential they might
seem to you.
5. When youre done, put down the marker and step back a few feet from the board or pad. Tell
yourself, Tese are merely my thoughts. Tey are not me. I am much more than these thoughts.
6. Feel the distance between you and these unhelpful thoughts. Try stepping back even farther, to
put more distance between you and these unhelpful thoughts.
7. Keep moving back a couple of steps at a time until you can feel your connection with your
thoughts loosening.
8. How do these thoughts feel now?