122 -Dialectical Behavior Therapy Part 1 Understanding Dialectical Theory
Counselor Toolbox

 
 
00:00 / 50:31
 
1X

Dialectical Theory
Facilitator: Dr. Dawn-Elise Snipes

CEUs for this webcast can be earned through ondemand classes found at CEUs are available for this podcast at https://www.allceus.com/member/cart/index/product/id/665/c/

Objectives
~    The Basics of DBT
~    The B in DBT: What You Need to Know About Behavior
~    Mindfulness
~    Reducing Emotional Reactivity
~    Distress Tolerance Skills
~    What Clients Need to Know About Emotions
~    Regulating Painful
~    Increasing Positive
~    Helping Clients Become More Effective In Relationships
The Clients
~    Emotional Vulnerability
~    React to things others wouldn’t react to
~    Reaction is more intense than others
~    Recovery time is longer than for others
~    Inability to Regulate Emotion
~    Difficulty identifying/labeling emotions
~    Difficulty understanding why they feel that way
~    Difficulty expressing the emotion in an effective way
Dialectical Theory
~    Everything is interconnected (Action/reaction)
~    Examine examples of action/reaction
~    Addiction
~    Anger
~    Depression
~    Social Interactions
~    Reality is in a constant process of change
~    How you perceive something now may be different than how you perceive it in an hour?
~    What changes perceptions?
~    What does the emotional mind say? The reasonable mind? The wise mind?

Dialectical Theory
~    The truth (always evolving) can be found by integrating multiple perspectives, and tolerating that two opposite things may co-exist
~    Simultaneous (understanding things differently by taking multiple people’s perspectives of the same event)
~    Example: Crime scene
~    Example: Interpersonal disagreement
~    Longitudinal (understanding things differently as knowledge is gained)
~    Example:  Mommy had no use for us and that is why she left.
~    Example: Mommy loves me, but she beats me, so I must be bad.

Skills Training Groups
~    Core Mindfulness
~    Increase self-awareness of thoughts, feelings and urges
~    Develop an understanding of emotions as things that do not have to be acted upon
~    Interpersonal Effectiveness
~    Develop assertiveness skills
~    Identify the goals of relationships and skills/activities needed to achieve those goals
Skills Training Groups
~    Emotion Regulation Skills
~    Label and effectively communicate feeling states
~    Understand the function of emotions and why we don’t want to eliminate them
~    Learn the connection between thoughts, feelings and behaviors and how to break the chain
~    Distress Tolerance Skills
~    Survival skills/alternatives to self-harm

DBT Assumptions
~    Clients are doing their best
~    They want to get better
~    They need to work harder/smarter and be more motivated
~    Even if clients didn’t create their problems, they have to fix them
~    Clients need to learn to act skillfully in EVERY area of their lives
~    Clients cannot fail in therapy
Treatment Priorities in DBT
~    Suicidal or self-harming behaviors
~    Behaviors that interfere with therapy (including clinician)
~    Suicidal or self-harm ideation and misery
~    Maintaining treatment gains
~    Other goals identified by the client

Mindfulness
Emotion Regulation
Interpersonal Effectiveness
Distress Tolerance
Stages of Treatment
~    Stage 1: Attaining Basic Capacities
~    Identify behaviors that pose a direct threat to the clients (or other’s) safety
~    Monitor the frequency, intensity of behaviors using a Behavior Tracking Form
~    Address
~    Suicidal/self-harming behaviors
~     Behaviors that interfere with therapy
~¬†¬† ¬†Suicidal ideation and ‚Äúmisery‚ÄĚ
~    Maintaining treatment gains
~    Client initiated goals
Stages cont…
~    Stage 2 Reducing Traumatic Stress
~    Subgoals
~    Negative relationships experiences related to emotional dysregulation
~    Lack of interpersonal skills
~    Stage 3 Increasing Self-Respect and Achieving Individual Goals
The ‚ÄúB‚ÄĚ in DBT
~¬†¬† ¬†Benefits–Positive and Negative Reinforcement
~¬†¬† ¬†Punishment ‚Äď Positive and Negative
~    Consequences
~    Negative
~    Positive
~    Neutral
~    Intermittent reinforcement (variable interval or ratio)
~    Modeling
The B In DBT
~    Reinforcers: Increase the likelihood of a behavior
~    Punishments: Reduce the likelihood of a behavior
~    Vulnerabilities: Increase the likelihood of fight or flight responding
~    Backward Chaining
~    Outburst Co-Worker said something insensitive  Felt drained upon awakening Had to put cat down the day before
The B In DBT
~    Triggers (+/-)
~    Cause a reaction
~    Remind the person of a prior situation in which a behavior was:
~¬†¬† ¬†Rewarded‚ÄĒLashing out makes gave client control
~¬†¬† ¬†Punished‚Äď Lashing out did no good increasing client‚Äôs sense of helplessness
~    Communicate to the person there is a threat
~    Prompt feelings of wellbeing

The ‚ÄúB‚ÄĚ in DBT
~    Shaping
~¬†¬† ¬†Rewarding/reinforcing ‚Äúsuccessive approximations‚ÄĚ
~    Example: Anger
~    Level 1: Not throwing things or being physically aggressive
~    Level 2: Disengaging until the urge to be verbally or physically aggressive was gone
~    Level 3: Being able to calmly discuss issues/problems

The ‚ÄúB‚ÄĚ in DBT
~    Shaping
~    Example: Addiction or other self-harm
~    Level 1: Engaging in secondary coping behavior (smoking, walking, eating, listening to music, drawing)
~    Level 2: Taking a mindfulness minute to evaluate the situation, then choosing a behavior consistent with goals

Mindfulness
~    Developing an in-the-moment awareness of how you are:
~    Emotionally
~    Mentally
~    Physically
~    Exploring the interconnection of thoughts, feelings and physical sensations
~    Distress in one leads to distress in others
~    Becoming aware of the emotional wave

Reducing Emotional Reactivity
~    Reduce Vulnerability: (Please)
~    P & L Treat Physical Illness
~    Eating
~    Altering Drugs
~    Sleep
~    Exercise
~    Build Positive experiences
~    Be mindful of current emotion

Distress Tolerance
~    Activities: Do hobbies, watch a video, go for a walk
~    Contribute. Do volunteer work
~    Compare yourself to people coping the same as or less well than you
~    Emotions. Distract with opposite (i.e. Comedy)
~    Push away a distressing situation by leaving it mentally for awhile.
~    Thoughts. Think about something else (Puzzles, book)
~    Sensations. Distract with intense sensations

What Clients Need To Know About Emotions
~    Increasing the Positive
~    Decreasing the Negative
Interpersonal Effectiveness
~    Assertiveness
~    Distress tolerance
~    Emotion identification and communication
~    Understanding
~    Your needs
~    The needs of others
~    Exploring situations using dialectical theory

Interpersonal Effectiveness
~    DEARMAN РGetting what we want/need:
~    Describe our situation.
~    Express why this is an issue or need and how we feel about it.
~    Assert: Sharing clearly what we feel and asking directly for what we want/need.
~    Reinforce our position by offering a positive outcome (win/win)
~    Mindful focusing on what we are requesting
~    Appear Confident
~    Negotiate
Summary
~    DBT is a great tool to help clients
~    Become more aware of emotions
~    Identify the thoughts, feelings and urges associated with emotions
~    Develop a greater sense of self-awareness regarding
~    The whys of emotions
~    Vulnerabilities which make them more likely to be emotionally reactive or sensitive
~    Provide a framework for teaching skills groups that benefit an array of clients who have difficulty with emotionality.

By continuing to use the site, you agree to the use of cookies. more information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close