DBT
What does DBT stand for?
Dialectical Behavioral Therapy
What is the first goal of distress tolerance?
To survive crisis situations, without making them worse
What are the six crisis survival skills?
STOP, Pros and Cons, TIPP, ACCEPTS, Self-Soothe, IMPROVE
What does STOP stand for?
Stop
Take a step back
Observe
Proceed mindfully
How can we practice pros and cons?
When in a crisis, we can do pros and cons. We can keep this list for future crisis scenarios. We can also "cope ahead" by practicing the pros and cons skill / creating a pros and cons list before a crisis occurs.
1. Create or review pros and cons lists
2. Then review the short vs long term effects of each list item
What are the four modules of DBT that we cover in IOP?
Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance.
What is the second goal of distress tolerance?
To accept reality. To replace suffering and being "stuck", to be able to more forward.
We are in a crisis when the situation is ____.
Highly stressful, short-term, creates intense pressure to resolve something now.
What does TIPP stand for?
Tip the Temperature
Intense Exercise
Paced Breathing
Paired Muscle Relaxation
What is Self-Soothe?
It is "soothing" each of our senses (vision, hearing, smell, taste, touch).
What skill does our group practice together on Thursdays?
Accumulating positives! (Watching WeRateDogs)
What are the two sections of the distress tolerance module?
Crisis survival and reality acceptance
How do we know if we are in a crisis or when to use crisis survival skills?
When we have an intense pain that cannot be helped/ relieved quickly.
When acting on our intense emotions will only make things worse.
When our emotion mind threatens to take over.
When we are overwhelmed, but demands must still be met.
When arousal is extreme, and the problem(s) cannot be solved immediately.
What does ACCEPTS stand for?
To distract with:
Activities
Contributing
Comparing OR Creating
Emotions
Pushing Away (Temporarily!!)
Thoughts
Sensations
How might one practice the Temperature part of TIPP?
1. Dipping our head into a bowl of ice water
2. Fill a zip lock bag with cold water / ice and put it over our eyes and temples
3. Grab an ice pack, frozen veggies, ice cubes, etc, and put it over your eyes and temples.
4. What else have you tried?
What skill has been most useful to you so far?
(I'm interested in everyone's thoughts!)
What is the third goal of distress tolerance?
To "become free" of having to satisfy the demands of our emotional desires, urges, and intense emotions.
Scenario: You're feeling increasingly overwhelmed in group (or in a group setting). What skills might you be able to use? Any you can use without others "noticing"?
No one specific answer here! Some examples might be: grounding with our 5 senses or self-soothing, paced breathing / deep breathing, STOP, ACCEPTS by stepping away for a moment .....
What does IMPROVE stand for?
Imagery
Meaning
Prayer
Relaxing
One thing in the moment
Vacation
Encouragement and Re-thinking
How do we know if a crisis survival skill worked?
We feel better. The situation stayed the same or did not get worse.
What's Ashlie's (the group therapist) favorite skill?
The TIPP skill!
What's the name of the scale we use to decide our level of distress? (It can be used to decide our current level, or reflect on what past levels have looked like)
The SUD scale!
Why do we want to be weary of / avoid using crisis survival skills when we are NOT in a crisis.
We run the risk of increasing our level of distress because the skill feels like it didn't work.
What is the Dive Response?
(aka mammalian reflex) A biological reaction that occurs when our faces are immersed in water (especially cold water). Your heart slows down, blood flow to nonessential organs is reduced, and blood flow is redirected to the brain and heart.
Scenario: Your thoughts are spiraling or catastrophizing and you need to stop the escalation. What might the goal of using a skill be?
To survive the moment without making it worse (NOT to problem solve right away).