Written by Sabrina Spotorno, LCSW, CASAC
Burnout isnāt just stressāitās what happens when stress piles up without the chance to recover. Whether it's a student juggling school and emotions, a teen navigating identity and pressure, or a therapist carrying the weight of othersā stories, Dialectical Behavior Therapy (DBT) offers a way to respond rather than collapse.
A useful combination for clients (and clinicians, too!) involves integrating DBT with the 4 Aās of stress management: Avoid, Alter, Accept, or Adapt. These ideas show how DBT skills and stress strategies come together in a Teleo session to spark insight and introduce actionable steps.
Avoid: Protecting Energy When Possible
Avoidance sometimes carries a negative connotation, but it can be a compassionate and protective choiceāespecially when it helps a client better understand personal needs and manage overwhelm. Teaching clients the difference between healthy boundaries and emotional suppression is key.
DBT Tie-in: Interpersonal Effectiveness
Introduce DEAR MAN and Boundary-Setting Skills to support clients say ānoā to tasks, people, or situations that consistently drain them. Search the Activity Bank for DBT Tools for curated psychoeducational activities.
Have clients create a "No List"āexamples of things theyāll avoid for their mental health. Then, help them build an ACCEPTS menu for when setting boundaries feels difficult.
ACCEPTS is a strategy for healthy distractionāalternatives that clients can actively say yes to.
š”Pro Tip:
Use the whiteboard to help clients make their ACCEPTS and "No List". Use talk mode, or search in the Activity Bank for puppets and a comic strip as creative tools to role-play boundary scripts!
š Care for the Clinician
š Care for the Clinician
Identify weekly energy drains and intentionally decline unnecessary tasks. Make space to recharge with the things that provide energy in return.
Alter: Changing the Situation, Even Slightly
Some stressors canāt be avoidedābut they can often be tweaked. Altering a situation may involve asking for help, shifting engagement patterns, or restructuring routines for manageability.
DBT Tie-in: Emotion Regulation + PLEASE skills
Get back to basics- use the PLEASE skills- to support clients in reflecting on their foundational self-care needs.
Explore how clients' physical wellness affects their emotional resilience.
Collaborate to develop a manageable weekly plan with small self-care goals, breaks, and realistic timelines.
The Weekly Goal Planner from WooJr, found in the Activity Bank, is a worksheet that can be used to track clients' self-care goals.
š”Pro Tip:
Use What Fills You Up? by Teleo as a creative way to explore what drains or fills a client's energy. Learn more about this activity and other tips in the article Building Strengths in Youth Clients.
The Plan of Action from Jared's Journal is a helpful worksheet to guide clients in reflecting and creating steps for overwhelming situations.
š Care for the Clinician
š Care for the Clinician
Introduce micro-recovery rituals between sessionsā2-minute stretches, breath resets, or grounding activities to alter the pace of a demanding workday.
Accept: Sitting With What Canāt Be Changed (Yet)
Acceptance can be challenging, but learning to sit with realityāwithout approving of itācan ease suffering.
DBT Tie-In: Radical Acceptance + Mindfulness
Support clients in identifying whatās out of their control and guide them in responding with non-judgmental awareness.
Practice different mindfulness exercises during the session. Teleo makes it easy to practice in a variety of ways- videos, books, and more.
š”Pro Tip:
Create a Radical Acceptance mantra, "It is what it is right now,ā and display it as a room poster. Learn how to personalize the Room Poster.
š Care for the Clinician
š Care for the Clinician
Recognize what burdens may not belong to the clinician to carry or solve. Allow space for discomfort without self-criticism. This is toughāand it's part of the work.
Adapt: Expanding Capacity to Handle Stress
Burnout prevention isnāt always about removing stressorsāitās often about building resilience and flexibility in response.
DBT Tie-In: Distress Tolerance + Building Mastery
Collaborate with clients on the whiteboard to create a "Burnout Toolkit" with go-to coping strategies (TIPP skills, distraction activities, sensory grounding).
Pair this with mastery-building tasks to strengthen self-confidence and perceived competence.
š”Pro Tip:
Trackers can help clients see how often they use coping skills and reflect on their impact. Try the Anxiety Coping Skills Tracker by Jennifer Ruefāit's easy to personalize through drawing or writing together.
š Care for the Clinician
š Care for the Clinician
Choose one ritual per week that builds resilienceāthen protect it as a non-negotiable anchor.
To help clients release stress, itās the small, consistent strategiesātailored through the 4 Aās and DBT skillsāthat make the biggest impact. Teleo supports clinicians and clients by creating an environment that encourages reflection, tracking, and planning, making healing more accessible.
At Teleo, we know caring for clients starts with caring for yourself.
āØ A full cup doesnāt just pourāit overflows. Refill early, not just when itās emptyāØ.
Join the Teleo Community for support, share ideas, or submit an activity.
āļø Sabrina Spotorno, LCSW, CASAC, is a NY-based clinical social worker, group practice owner, and clinical supervisor, licensed in New Jersey, Arizona, and Iowa. A firm believer in the healing power of play, Sabrina uses playful connection as a therapeutic bridgeāhelping children process big emotions, build inner resilience, and explore their unique strengths. She also centers sustainability in her work, supporting burnout prevention not only for clients and families but for fellow clinicians navigating the demands of this field.
Learn more about Sabrinaās work at compassionatetalktherapy.com