DBT Overview
Who created DBT?
Bonus (+100) - What diagnosis was DBT originally created to support?
Marsha Linehan
Borderline Personality Disorder
What are the three "WHAT" skills of mindfulness?
Observe. Describe. Participate.
What is the main goal of distress tolerance?
To survive crisis situations without making them worse!
What do you do when you're having an action urge but the emotion does not fit the facts or acting on the emotion would not be effective?
OPPOSITE ACTION!
Your objective is to get what you want from a friend, while maintaining the relationship. What two IE skills do you need?
Bonus (+200) - what does each acronym stand for?
DEARMAN, GIVE
Describe, express, assert, reinforce, (be) mindful, appear confident, negotiate
(Be) gentle, (act) interested, validate, (use an) easy manner
There are four components of Dialectical Behavior Therapy. Name the three components that directly involve you, the client.
1) Skills training
2) Individual therapy
3) Phone coaching
What are the "HOW" skills of mindfulness?
Nonjudgmentally, one-mindfully, effectively
Oh no! Your SUDS are 80, and you're about to act in a way that may make things worse... what skill do you need to do first?
STOP - stop, take a step back, observe, and proceed mindfully
Describe 3 sleep hygiene practices
Follow a consistent sleep schedule
Do not use your bed during the day
Turn off electronic devices before you go to sleep
Go to bed only when you’re tired
Limit napping — or avoid it if you can
What may get in the way of communicating effectively?
You don't know what you want. Your emotions are too high. You prioritize short-term goals vs. long-term goals. Others don't have the skills. Your thoughts and beliefs.
When life presents you with problems, DBT says there are five options. Name any 3 of the 5 options.
1) solve the problem 2) feel better about the problem 3) tolerate the problem 4) stay miserable 5) make it worse
What are the three states of mind, and which state of mind do we aim to act from?
Reasonable mind. Emotion mind. Wise mind!!
You're sitting in class (or at work), and your SUDS are 75. What TIP skill can you use to help you stay in class and refocus?
P - paced breathing or progressive muscle relaxation
Pair the following emotions with their action urges:
a. anger
b. fear
c. shame
a. attack, get loud, tense, walk away
b. flee, avoid, cry for help, freeze
c. hide, avoid, withdraw, overly apologize
Your classmate (whom you're not super close with) asks for the 5th time to copy your homework before class this month. You want to say no, while maintaining self respect. What skill do you need?
Bonus (+100) Explain how you would use it.
FAST - be fair, no apologies, stick to values, be truthful
What theory is DBT rooted in to help explain why clients have so much trouble controlling their emotions and actions?
Double jeopardy! Accurately describe the components of the theory.
Biosocial theory
Biological - Emotional vulnerability [People are born more sensitive - feel emotions more often, more intensely and have a slow return to baseline] Impulsivity [regulating action is harder for some]
Social - Invalidating or ineffective social environment
Why bother with learning to be mindful (i.e., what are the goals of mindfulness)?
Increase awareness and gain control over your mind. Reduce suffering and increase happiness. Make effective decisions. Improve focus and attention. Increase compassion towards self and others. ETC.
Distracting with ACCEPTS is an effective way to tolerate distress. List a skill for each letter.
Double jeopardy! What is the risk of overusing distraction?
Activities, Contributing, Comparisons, Emotions, Push Away, Thoughts
Distraction doesn't solve the problem and can become avoidance.
What is the difference between accumulating positive emotions in the short-term and long-term?
Give an example for each.
Short-term: do pleasant things that are possible now (e.g., watch a funny show)
Long-term: value-/goal-oriented; make changes in your life so that positive events will happen more often in the future (e.g., value: fitness, attend a strength training class)
Validation is finding the ______ __ _____ in another person's perspective of a situation. Validation is NOT necessarily ________.
kernel of truth; agreeing
There are seven DBT assumptions that clients and therapists agree to abide by throughout treatment. Name one of the seven.
1) People are doing the best they can. 2) People want to improve 3) People need to do better, try harder, and be more motivated to change 4) People may not have caused all their problems, but they have to solve them anyway. 5) New behavior has to be learned in all relevant contexts. 6) All behaviors are caused. 7) Figuring out and changing the causes of behavior work better than judging and blaming.
What modules of DBT do you need to incorporate mindfulness?
ALL! Distress tolerance, emotion regulation, interpersonal effectiveness, walking the middle path
In what situations is practicing radical acceptance effective?
An unpleasant event that cannot be changed or a change cannot be identified without acceptance
The purpose of PLEASE skills are to take care of your mind by taking care of your body. Identify how you did (or could have) practiced all 5 skills this week.
Treat ___ ___, balance ___, avoid ___ ___ ___, balance ___, and get ___.
Treat physical illness - meds as prescribed, rest when tired, ice an injury
Balance eating - everything in moderation
Avoid mood altering substances ;)
Balance sleep - 8-10 hrs! Consistent wakeup time
Get exercise - go for a walk!
Being dialectical requires balancing opposites. What is the main dialectic that DBT seeks to balance?
Double jeopardy! Identify the appropriate skills modules for each.
Acceptance and change
Acceptance: mindfulness, distress tolerance
Change: interpersonal effectiveness, emotion regulation