by Kerrie Toole, LICSW
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Holidays can be a time of togetherness and celebration for many, while for others, there can be significant amounts of stress and loneliness. This time of year, I often work with my clients to develop a “Cope Ahead” plan for the holidays, so they can be prepared for tensions or stressors that often arise.

The first step of creating a “Cope Ahead” plan is to get clear on what your boundaries and limits are, before going into any particular setting. Boundaries are internal facing - these are developed by having self-awareness of where your vulnerabilities or sensitivities are, and what you will or will not do in response to your environment. Limits are external facing - for example, how do you express to someone that you are not comfortable continuing a discussion on a certain topic, or how do you talk with someone about expectations prior to an event. 

The best way to confidently set boundaries and limits that stick is to be proactive. When we are already in a stressful situation and try to set boundaries and limits in the heat of the moment, our actions may come from a place of overwhelm. If overwhelmed, we may overshoot the mark of what we are trying to accomplish, and then later feel guilty. By creating a structured plan ahead of time, we can avoid going into a holiday event feeling on edge and waiting for that “thing” that often happens that leads us to explode or feel hurt, angry, or sad. Instead, we can have confidence in a rehearsed response, and go into situations expecting to be effective when faced with a challenging interaction.

It’s important to note here that sometimes being effective is not necessarily about being “right.” If we try to convince others with a different view that our perspective is “right” and they are “wrong,” usually that results in an argument. That’s probably not the energy we’re looking for during a holiday gathering. So we can ask ourselves, “what is the most effective thing I can do in this situation?” Consider how you want to feel about yourself and your choices. What will make you most proud of yourself?

Part of planning ahead of time for the holidays is to have a game plan about what resources you can use during times of stress, and that those resources are available when needed. Here are some of the common questions I ask clients when we are developing their “Cope Ahead” plan for the holidays:

1. What events that could cause you distress are likely to happen? What dynamics have happened in the past that might happen again? 
2. Will you be by yourself during all or part of the holiday? What would make those moments more comforting for you? 
3. How do you usually feel on the holiday? At family events? When on your own?
4. What is the most effective way that YOU can respond to comments or situations? You may want to yell and scream, but would that actually do anything productive?
5. What are YOUR boundaries on tolerating others’ statements or actions?
6. What is your strategy if that boundary is challenged? Is there an effective way to end a discussion where you are feeling overwhelmed? Worst case, is there an effective way to leave the gathering, if needed (think about parking and how to make sure you can get out easily, or drive yourself)? 
7. Who are your allies at a gathering? Can you work together for support by giving each other glances from across the room or by sticking together?
8. Gamify it! Use a website to randomize invalidations, comments, and annoyances that you are likely to experience into Bingo cards and pass them around to people closest to you, and whoever gets Bingo by the end of the night gets a prize. Maybe each of you in your friend group is at their own holiday function and can share updates on group messages. Or, each of you keep count of how many times you effectively manage a complicated situation and whoever has the largest number at the end of the night “wins.”

In order to be most prepared in challenging situations, I recommend that people document their “Cope Ahead” plans on their phones or on paper, and keep the plans with them. If you plan to use coping strategies such as a soothing smell, a fidget, coloring, an ice pack for your face to cool yourself down, etc., be sure to bring those items with you. Additionally, having another person to remind you of your “Cope Ahead” plan in the moment could be quite helpful - think of a code word that can be a reminder or a signal that you have effective skills that you can apply.

By taking a proactive approach to planning effective responses to stressful situations, holiday events can be more enjoyable (or at least tolerable) this season.

By Niamh Smithers, M.A.

Whether you get along with your family, have difficult family relationships, celebrate holidays with friends, or don’t celebrate certain holidays at all, this time of year can bring up a lot of mixed emotions for people. Not only are there often added stressors around finances, relationships, and social obligations, but the time change and colder weather can impact each individual differently. And while each person is unique in how they navigate the stressors involved with this time of year, it can be helpful to prepare a plan ahead of time for how to handle difficult emotions or situations to feel more confident going into these experiences. 

I often find myself struggling during this time of year due to the lack of sunlight, the colder weather, and the overstimulation involved with holiday shopping, socializing, etc. My family typically hosts Thanksgiving and Christmas gatherings, which can make it even more difficult to set limits around how much time I’m spending with family. I find myself wanting to escape to charge my “social battery” when it’s running low more regularly, too. Whether you’re the house hosting, traveling for the holidays, or having a solo stay-cation this winter season, here are some helpful tips to prepare yourself: 

1. Manage physical vulnerabilities

• Eating regularly, drinking enough water, moving your body, taking your medications (if this applies to you), limiting caffeine and prioritizing quality sleep in the days leading up to and following potentially stressful or anxiety provoking situations can help support you in managing intense emotions or conflicts more effectively if/when they arise. Engaging in self-care can support you in proactively reducing your susceptibility to fatigue, illness, mood fluctuations, etc. 

  2. Check-in with your emotions

• Do you experience physical sensations or thoughts that help you in recognizing different emotions? Perhaps your heart rate increases or you have more difficulty regulating your breathing when you’re feeling anxious. Or maybe you get a sinking feeling in your stomach if someone makes a comment that hurts your feelings and leads to negative self-talk thoughts. Identifying your “cues” to different emotions can be a helpful first step for understanding how to regulate those different emotions and feel more confident feeling your way through difficult moments. 
• Some individuals may find it helpful to identify certain family members or topics that are likely to activate intense emotions and collaboratively brainstorm a script or role-play handling those situations with your therapist.

3. Make a list of enjoyable activities

• Sometimes when we are feeling intense emotions, we can forget what tools help us feel better in the moment. Having a list of or access to hobbies or relaxing activities can help to easily remind yourself of ways to boost your mood, decrease anxiety, or take a moment for yourself when there is too much going on around you. Some examples could be: bringing a book to read, planning to go for a walk, coloring activities, listening to music or spending time with your pets.

4. Make your “escape” plan:

• While we are unable to control other people’s actions or words, or sometimes even the environments we find ourselves in during the holidays, we can create a sense of control by coming up with ways to take a moment for ourselves to regroup if emotions or tension rises. 
• For example, sometimes when I am feeling overwhelmed or overstimulated, I will say my dog “needs to go outside” and I will go outside with him. Whether he actually needs to go outside or not, it gives me a second to get fresh air, regulate my emotions, and spend time away from other people. 
• Another example could be: taking a separate car if you are able or collaborating with other family members about what time you’d like to leave before you arrive at various events to feel prepared and honor your limits around spending time with others or in stressful environments.​

  5. Be kind to yourself!

• This time of year can carry a lot of pressure whether societally, from our families, or from ourselves. Practicing positive self-talk and self-compassion can help support you in feeling grounded in yourself. Telling yourself, “I can do hard things”, “I’ve survived 100% of my worst days”, “I am enough just the way I am” or reminding yourself of something you have to look forward to in the future can be a great way to go into this stressful time of year with at least one person in your corner…YOU! 

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By Kerrie Toole, LICSW, Executive Director 

As September marks National Suicide Prevention Month, it’s a meaningful time to reflect on the resources available when we or someone we care about faces a mental health crisis. While many people are familiar with emergency numbers like 911, 988, or the Samaritans hotline, there are also other, often more accessible, options for getting help right in your community. Today, I want to walk through what you can expect when seeking emergency mental health services, so that if the time comes, you feel informed and supported.

Resources You Can Turn to in a Crisis

For those in Massachusetts, the Massachusetts Behavioral Health Help Line offers real-time support 24/7. Whether you prefer to call or text, help is just a moment away at 833-773-2445. Additionally, Community Behavioral Health Centers (CBHCs) provide 24/7 walk-in services, as well as mobile services, meaning they can come to your home or another location if that’s where you feel safest. You can find more details about these services here.

If you're local to the Metrowest area of Massachusetts, there are several Emergency Service Provider (ESP) agencies that can conduct emergency assessments and provide care without needing to go to the emergency room. In some cases, these agencies are also the ones conducting evaluations if you do go to the ER. Here's a quick guide to some of these providers:

• Advocates, Inc. in Framingham: 800-640-5432
• Riverside Community Care in Milford: 800-634-3420
• Community HealthLink in Worcester: 866-549-2142
  You can also use this link to find the provider closest to your town.

What Happens During an Emergency Mental Health Evaluation

Whether you’re evaluated in an emergency room, at a CBHC, or through an ESP agency, the process is quite similar and designed with care and thoroughness in mind. A trained clinician will meet with you—and any supportive person you have with you—to assess the situation. They’ll look at both risk and safety factors and, with your permission, may gather additional information from any mental health providers you’re currently seeing.
Once the clinician has all the necessary information, they’ll consult with a team of professionals to determine the most appropriate level of care for you. This could be anything from a referral for outpatient services to inpatient hospitalization. If you're in an emergency room, there will be an added step of a medical evaluation to ensure there are no underlying physical issues that need attention.

Understanding Your Care Options

After an evaluation, the agency will help you access the right level of care. Here’s a breakdown of what that could look like:

• Inpatient Hospitalization: If you’re in immediate danger or at high risk, this is the highest level of care. Inpatient facilities, whether part of a hospital or standalone, are secured units with 24/7 care. You’ll have access to therapy, medication management, and support from a team of specialists.
• Partial Hospital Program/Day Program: This option provides structured therapy and support during the day, but you return home at night. It’s often a step down from inpatient care and includes group therapy, individual sessions, medication management, and case management.
• Intensive Outpatient Program (IOP): For those who don’t require the intensity of a day program, IOPs offer therapy for around 9-12 hours a week, spread across several days. It’s a great option for those transitioning back to regular life but still needing structured support.
• Community-Based Acute Treatment (CBAT) for Children and Adolescents: For younger people who need more than outpatient care but not full inpatient hospitalization, CBAT offers a safe, supportive environment with therapeutic care. It is a 24/7 unit located in the community, and stays are typically around two weeks. Services such as individual therapy, family therapy, medication management, and group therapy are provided.
• Outpatient Services: If the situation doesn’t require a higher level of care, the agency will ensure that you’re connected with an outpatient therapist or provider before the crisis evaluation is over. This is key to ensuring ongoing support after the immediate crisis passes.

You May Not Need to Go to the Emergency Room

In many cases, you can access these services without stepping foot in an emergency room. By reaching out directly to your local ESP or CBHC, you can get the help you need in a more familiar, less overwhelming environment.


Navigating a mental health crisis can be a deeply personal and often overwhelming experience, but knowing what to expect and who to call can make all the difference. Whether it's through a quick text, a phone call, or a walk-in appointment, support is available—and it’s closer than you might think. If you or someone you know is struggling, don’t hesitate to reach out. There’s help, hope, and people ready to stand by your side.

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