1 / 20

Dialectical Behavior Therapy: (DBT)

Dialectical Behavior Therapy: (DBT). Philosophy and Applications. DBT Clientele Attributes. Unbalanced interpersonal relationships Unstable self-image Impulsivity Recurring suicidal or self-harming behavior Mood instability Perfectionism Attachment / abandonment issues Borderline traits.

lew
Download Presentation

Dialectical Behavior Therapy: (DBT)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dialectical Behavior Therapy: (DBT) Philosophy and Applications

  2. DBT Clientele Attributes • Unbalanced interpersonal relationships • Unstable self-image • Impulsivity • Recurring suicidal or self-harming behavior • Mood instability • Perfectionism • Attachment / abandonment issues • Borderline traits

  3. DBT Incorporates: • Dialectics • Zen tradition • Cognitive behavioral therapy

  4. DBT PhilosophyDialectical Worldview • Interconnectedness • Opposing forces. • Thesis – Antithesis – Synthesis – Thesis – Etc. • Walking the middle path. • Change is constant. • Example: Cutting relieves emotional pain versus health implications and dangers= Finding healthy ways to relieve emotional pain.

  5. Choose the Dialectical Statement • People hate me / everyone thinks I am the coolest / some people enjoy being around me and others do not. • I can’t do anything right / I have strengths and things I am learning / I have it all figured out • There are things I like and dislike about others/ I hate them / They are so perfect

  6. DBT PhilosophyZen Tradition • Mindfulness • Wide mind • Non-judgmental stance • Observing • Acceptance as a balance to change • Irreverence versus warmth • Radical acceptance • Example: Clients may not have caused all of their own problems, AND they have to solve them anyway.

  7. DBT FilosophyCognitive Behavioral Therapy • Thoughts, feelings, behaviors. • Eliminate negative secondary gains. • Example: Crisis call to therapist after self-harming, therapist will ensure 911 is called and call will end. • Behavior skills training. • Example of Dear Man

  8. Mindfulness Activity What Skills: How Skills: Observe: Pay attention to what is Non-Judgmentally: See and do not going on around you. 5 senses. evaluate. Do not judge your judging. Describe: Use words to say what Stay Focused: Do one thing at a time, you are observing. let go of distraction, concentrate. Participate: Enter the experience Do What Works: Act skillfully, play by fully. the rules, let go of feelings that hurt you.

  9. Biosocial Theory of BPD • Emotional vulnerability • Invalidating environments. • Biological issues. • One cannot ignore the 75% prevalence of sexual abuse among those diagnosed with BPD.

  10. DBT Therapy Assumptions • Clients are doing the best they can. • Clients want to improve. • Clients need to do better, try harder, and be more motivated to change. • Clients must learn new behaviors in all relevant contexts. • Clients cannot fail in DBT. • Clients may not have caused all their problems, and they have to solve them anyway. • The lives of suicidal BPD clients are unbearable as they are currently being lived.

  11. Modes of DBTIndividual Therapy • Individual therapist is main contact. • Commitment to program and safety • Eliminate life threatening and therapy-interfering behaviors. • Improve quality of life. • PTSD treatment, application of skills, and self concept development. • Processing is to take place in individual therapy.

  12. Links and Chains Mad Lib

  13. Modes of DBTGroup Skills Training In parallel with individual therapy – skills focus. • Core mindfulness • Interpersonal effectiveness • Emotional regulation • Distress tolerance • Walking the middle path

  14. Interpersonal Effectiveness Activity • Validation Exercise

  15. Modes of DBTTelephone Consultation • Individual therapist contact. • Support and assistance with skills before crisis. • Clear limits and boundaries.

  16. Distress Tolerance Activities • Radical Acceptance • Ice • Pros and Cons of unhealthy behavior

  17. Modes of DBTTherapist Consultation Meeting • Weekly meetings • Team acquires skills • Provides support • Integrates DBT philosophy • Plans treatment for clients.

  18. Emotional Regulation Activity • Rope Challenge

  19. DBT at Children’s Outpatient • 16 weeks of skills group. No more than 2 client absences. • Open ended with entry dates every 4 weeks. • Mandatory guardian and client attendance. • Staff supervision one hour weekly. • YOQ monitoring. • 2 hours of group and family/individual session weekly. • Broadened client symptomology.

  20. References • Linehan, M. (1993a). Cognitive- behavioral treatment of borderline personality disorder. New York, NY: The Guilford Press • Linehan, M. (1993b). Skills training manual for treating borderline personality disorder. New York, NY: The Guilford Press

More Related