Create Between-Session Coping Plans Clients Actually Use in Therapy

Triggers do not wait for the next session. Here is what I have actually seen make a difference.

1. Our clients are in court-mandated DUI treatment, so the pressure is already there when they show up. I ask them to tell me about the last time they almost slipped and we go from there. I do not hand them a plan. We build it together, around that one moment. Maybe it is getting out of the house when stress builds up or taking a different road home after a long day. When it is their idea, they stick with it.

2. Checking in with one person who knows they are in treatment, right after a tough situation. Talking through what happened and how they handled it builds confidence over time. They stop seeing themselves as someone who almost slipped and start seeing themselves as someone who got through it.

Every week I watch couples fail between sessions because they exhaust themselves trying to perfectly avoid conflict instead of preparing to survive it. To manage daily triggers, I teach them to stop litigating the content of their arguments and instead name the single frame they are trapped inside. The most reliable practice I offer is a brief verbal reset where one partner explicitly states out loud that right now we are both hurting and both protesting. This recognition instantly shifts their nervous systems away from mutual threat and drops them into the shared vulnerability of the Sovereign Us. Stop wasting your energy trying to ensure you never hurt each other, because the true magic of relationship happens in the repair.

When clients face triggers between sessions, the plan only works if it actually fits their daily life. So I co-create it with them rather than handing them a list. We walk through grounding and regulation techniques together in session, and we practice them then and there. Practicing in session matters because a technique a client has only heard about is much harder to access in a moment of activation than one they've already tried with their nervous system.

What I've found has the best uptake is matching the technique to the client's actual lifestyle, not assigning what I think is "best." For someone who's already active and outdoorsy, natural bilateral stimulation through walking is often the technique they'll actually use, because it integrates into something they're already doing. For someone whose primary struggle is anxiety and who tends to be less active, the 5-4-3-2-1 senses grounding exercise tends to land better, because it works anywhere and doesn't ask them to add a new routine. For someone with significant trauma history, the container exercise from EMDR is often the technique they keep returning to, because it gives them somewhere to put the activation rather than just trying to push through it.

I also lean on vagus nerve techniques like ice on the back of the neck, cold water on the face, or extended exhales, because they intervene directly at the physiological level when someone is already activated and can't think clearly enough to do a longer practice.

The piece that ties it all together is teaching clients to recognize their own early activation cues. We spend time identifying their specific triggers and the bodily and emotional signals that show up when their nervous system is starting to shift. That awareness is half the work. Once a client knows the cue, the regulation technique has somewhere to land. Without it, even the best technique gets remembered too late.

The brief practice that seems to have the best uptake across clients is the simplest one. When you notice the cue, do one regulation technique you've already practiced. Just one. The bar for follow-through has to be low enough that a struggling nervous system can clear it. Asking for more than that is what kills the plan.

Darin King, LPC
Founder & Clinical Director, Darin King Counseling LLC
darinkingcounselingllc.com

I sit on the operations side, not the clinical side, but I'm in enough internal reviews to see what patterns hold up across a large client base. The thing that consistently has the best uptake is radical simplicity. Plans that ask a client to do five things between sessions almost never get used. Plans that ask for one thing, tied to something they already do every day, get used.

The specific format I see work most often is a single if-then prompt the client helped write themselves. Something like 'if I notice my chest tightening before a meeting, I take three slow breaths before opening my laptop.' The client wrote it, so it sounds like them. It's anchored to a moment that already exists in their day, so they don't have to remember a new habit. And it's one line, so it fits on a sticky note or a phone lock screen.

The other thing that drives uptake is removing the performance element. Clients who feel like they're being graded on whether they did the homework tend to either over-report or disengage. When the between-session plan is framed as data collection rather than a test, people actually use it and bring back something useful to talk about.