TABLE 1.

The components of 4Ds, their definition, examples, and evidence.

Component	4D definition	Examples	Selected evidence from experimental research	Selected evidence regarding neural pathways
Control (an underpinning theoretical construct of 4Ds)	The user chooses, achieves and maintains their desired experiences.	Draw on users’ knowledge, skills, and experiences. Encourage users to consider, select, and test each strategy for themselves.	Loss of control is associated with distress and control is associated with wellbeing (Cheng et al., 2013; Tabibnia, 2020).	Chronic loss of control through dorsal raphe nucleus of the brain, reversal via medial prefrontal cortex (Maier and Seligman, 2016).
Distract	Everyday activities that shift attention away from distress for a period of time and improve mood.	Sport, exercise, social activities, nature engagement, music, daydreaming, and humor.	Distraction improves short-term mood (Webb et al., 2012); rewarding, and social, activities reduce distress (Tabibnia, 2020).	Multiple combined pathways including reward pathways (e.g., ventral striatum) (Tabibnia, 2020).
Dilute	Trained techniques that reduce current distress.	Applied relaxation, slow breathing, grounding, brief mindfulness, and thought challenging.	Applied relaxation is effective for anxiety (Kim and Kim, 2018); mindfulness training reduces stress (Khoury et al., 2015).	Reduced activation of autonomic nervous system and release of cortisol (Pascoe et al., 2017).
Develop	Plans to engage in discovery in a safe and constructive way.	Worry time, self-scheduling, drawing upon times they have previously coped and generating compassionate imagery.	Control over worry linked to reduced distress (LaFreniere and Newman, 2019); self-compassion interventions reduce distress (Ferrari et al., 2019).	Compassion recruits midbrain periaqueductal gray (PAG) (Simon-Thomas et al., 2012).
Discover	Shifting to and sustaining engagement with, and expressing the experience of distress to explore the source of conflicts to generate new perspectives.	Emotional disclosure, discovery talk (active listening), and expressive writing or drawing.	Active listening reduces distress (Jones and Cutliffe, 2009); expressive writing improves wellbeing (Travagin et al., 2015); effects of expressive writing mediated by conflict awareness (Kelly et al., 2012); higher level construals enhance personal growth (Wang et al., 2016).	Medial prefrontal cortex, amygdala, and autonomic nervous system (Saunders et al., 2017; Tabibnia, 2020).