Settle: A Free Body-First Options Worksheet for Adults with ADHD (Grounding, Movement or Breathing)

ADHD · Practice-informed · Practice-informed

A choice of three ways to settle the body before deciding what to do: grounding, movement or slow breathing. Breathing starts with nose-low-slow breathing and offers resonance breathing only later and only if wanted. The sheet lists stop signs, helps the client pick a cue and a skill and holds a seven-day practice log.

Underlying mechanism: Body-First Settling Options for Adult ADHD: Grounding, Movement and Optional Nose-Low-Slow and Resonance Breathing

What it helps with

Giving a client who finds stillness hard a movement or grounding route, so no one is set up to fail.
Keeping breathwork optional and honest about its evidence in ADHD.
Linking a skill to a cue, such as the moment a face goes hot or before replying to a hard message.
Treating a low rating in the log as useful information and not as failure.

How clinicians use it

Offer all three options at Session 3 and let the client choose. Do not make progress depend on breathing.
If breathing is chosen, teach nose-low-slow first and offer resonance breathing later only if it feels familiar.
Name the longer out-breath (about 4 in and 6 out) as a separate technique.
Review the practice log next session and change the option if the ratings are low.

Clinical Implementation Guide

Offer all three options and let the client choose.
Agree a cue and one small first move.
Review the practice log next session and adjust.

What the worksheet looks like

Settle: Body-First Options — worked example
Option	What it is	Good when
A. Grounding	Feet on the floor, name five things you see, four you touch, three you hear	Thoughts are racing or still practice feels hard
B. Movement	Walk for two to five minutes, shake out arms or stretch slowly	A surge is big and sitting still is hard
C. Slow breathing (optional)	Nose-low-slow breathing for 3 to 5 minutes, then resonance breathing only if wanted	The client likes breathing and it feels easy

Clinical cautions

Breathwork is optional. Stop and return to normal breathing for dizziness, tingling, lightheadedness or increased anxiety. Never use breath holds or fast deep breathing. Take extra care with asthma or other breathing conditions, panic disorder and trauma linked to breathing, and let the client skip breathing entirely. Counting can feel like pressure for some people with ADHD, so go back to nose-low-slow breathing, grounding or movement if so.

References

Sumińska, S., Rynkiewicz, A., & Szulczewski, M. (2026). Resonance frequency versus fixed 0.1 Hz breathing in HRV biofeedback: A four-week randomized comparison. Scientific Reports, 16(1), 22630. https://doi.org/10.1038/s41598-026-53333-6
Minjoz, S., Jeanne, R., Pellissier, S., & Hot, P. (2026). Psychophysiological effects of heart rate variability biofeedback versus sham biofeedback: A randomized controlled trial. Biological Psychology, 206, 109254. https://doi.org/10.1016/j.biopsycho.2026.109254
Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756. https://doi.org/10.3389/fpsyg.2014.00756

Copyright and use in research

Suggested citation (APA 7th edition): Pomfret, R. (2026). Steady the Surge: A skills-first, neuroaffirmative protocol for adults with ADHD and emotional surges (Version 1.0) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/

Part of

Steady the Surge

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