Final project
fadoo
DBT-1.pptDialectical Behavior Therapy
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General Overview
- Marsha Linehan
- Orientation combines systemic/transactional approach, CBT, Buddhism, and principles of Dialectics.
- Developed for use with persons with BPD, but has also been applied to suicidal behavior in adolescents and bulimia.
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Four Keys
- Mindfulness:
- focuses on improving an individual's ability to accept and be present in the current moment.
- Distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. relationships.
- Emotional Regulation:
- covers strategies to manage and change intense emotions that are causing problems in a person’s life.
- Interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens
Linehan’s Theory of the Development of BPD
- Based on a bio-social theory of BPD.
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- Philosophical perspective of dialectics: balancing opposites.
- Find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking.
- DBT promotes a both-and rather than an either-or outlook.
Therapists’ Working Assumptions about the Client
The client wants to change, and despite appearances, is trying his/her best as a particular time.
His/Her behavior pattern is understandable given his/her background and present circumstances.
In spite of this, he/she needs to try harder if things are to improve.
Clients can not fail at DBT.
https://www.youtube.com/watch?v=S4Ccpqh6giM
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Therapists’ Dialectical Style
- Reciprocal communication vs. Irreverent communication.
- Accepting of the client as he/she is, but encouraging change.
- Centered and firm, yet flexible when the circumstances require it.
- Nurturing, but benevolently demanding.
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Clients’ and Therapists’ Agreements
- To work in therapy for a specified period of time, and to attend the majority of therapy session.
- If suicidal or para-suicidal behaviors are present, he/she must agree to work on reducing these.
- To work on therapy interfering behaviors.
- To attend skills training.
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Modes of Treatment
Individual therapy.
Group skills training.
Telephone contact.
Therapist consultation.
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Skills Training
Core mindfulness skills.
Interpersonal effectiveness.
Emotion modulation skills.
Distress tolerance skills.
http://www.dbtselfhelp.com/html/dbt_skills__defined_.html
http://www.behavioraltech.com/index.cfm
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Individual Therapy
- Stages of therapy.
- Hierarchy of therapy targets.
- Treatment strategies.
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Stages of Therapy
- Pre-treatment.
- Stage 1: focus on suicidal behaviors and therapy interfering behaviors.
- Stage 2: focus on PTSD related problems.
- Stage 3: focus on self-esteem and individual treatment goals.
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Hierarchy of Therapy Targets
- Decreasing suicidal behaviors.
- Decreasing therapy interfering behaviors.
- Decreasing behaviors that interfere with quality of life.
- Increasing behavioral skills.
- Decreasing behaviors related to post-traumatic stress.
- Improving self-esteem.
- Individual targets negotiated with the client.
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Treatment Strategies
- Contingency management.
- Cognitive therapy.
- Exposure based therapies.
- Pharmacotherapy.
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