Levels of Distress
When at a SUDS level of 90+, the first skills you should use are these. (only need to name one of them)
Who created DBT?
Marsha Linehan
For triple points: name the three elements that Marsha combined to create the clinical framework for DBT (hint: existing therapy model + existing therapy model + existing practice)
Type of hunger that involves thinking about food.
Mental hunger
STOP
Stop
Take a break
Observe
Proceed Mindfully
For double points: which of the four skills modules is the STOP skill in?
True or false: a BCA is a punishment.
False: a BCA is an opportunity to shape ineffective behavior and celebrate effective behavior.
Emotion Regulation skills such as Check the Facts, Mindfulness of Current Emotions, and Cope Ahead are excellent tools for times when SUDS do not exceed this number.
70
True or false: in the DBT model, we assume that clients can and often do fail in treatment.
False: Clients cannot fail DBT, only DBT can fail clients.
List of challenging foods and beverages from least difficult to most difficult.
Food hierarchy
Identify what three of the letters in the IMPROVE acronym stand for.
Imagery
Meaning
Prayer
Relaxation
One thing in the moment
Vacation
Encouragement
For double points: which of the four skills modules is the IMPROVE skill from?
What are the four modules/types of DBT skills?
Mindfulness, Distress Tolerance, Emotional Regulation, Interpersonal Effectiveness
After lowering distress levels to a 6 or below using Distress Tolerance skills, you must:
A) Feel better forever
B) Use mindfulness skills to feel your feelings/be in the moment
C) Use more distress tolerance skills to prevent SUDS from getting high again
D) Use emotion regulation skills to further regulate your emotions/lower your distress and prevent SUDS from getting high again
D) Use emotion regulation skills to further regulate your emotions/lower your distress and prevent SUDS from getting high again
Why isn't C the answer? What about B?
Which method of shaping behavior is more likely to be successful: rewarding effective behaviors or punishing ineffective behaviors?
Rewarding effective behaviors
For double points: name 2 ACTIVE rewards for effective behaviors
A group of vitamins that require dietary fat for absorption is considered this.
Fat-soluble.
Contribution, Comparison
For double points: describe these two components of the ACCEPTS skill.
What are the WHAT skills of Mindfulness? (hint: there are three)
Observe, Describe, Participate
For double points: ~describe~ them.
Name three Distress Tolerance skills best used between the SUDS levels of 70 and 90?
Self-soothe, ACCEPTS (distraction), IMPROVE the Moment, Turning the Mind, Pro/Con, Half-smile/Willing Hands
Describe the dialectical dilemma of Active Passivity vs. Apparent Competence.
Active Passivity = lack of confidence in your ability to handle your own problems, so much so that you do everything in your power to get others to deal with them for you even when you do not realize it.
Apparent Competence = a) not properly conveying to others that you need assistance in some area AND/OR b) purposefully hiding your struggle so that others think you have everything figured out to avoid seeming vulnerable/weak; both lead to your needs not being met
For double points: identify which end of the dialectic typically aligns with under-controlled/over-controlled presentations.
For triple points: name one of the two other Dialectical Dilemmas.
The brain’s sole source of energy.
Glucose
ABC PLEASE*
*for our purposes
Accumulate positive emotions
Build mastery
Cope ahead
(treat) PhysicaL illness
Eat
Avoid substances
Sleep
*Eat again
While Pro/Con is technically a skill in the ______ skills module, it can also be used as a(n) _______ skill.
Distress Tolerance, Emotion Regulation/Mindfulness (both acceptable)
For double points: explain how Pro/Con is used in each type of way.
You're having really high purge urges. You have tried holding some ice, watching TV, and staying away from the bathroom, but you feel yourself coming to the end of your rope. How do you troubleshoot your skills use?
Explain the Biosocial Theory of Emotional Dysregulation/DBT
Biological sensitivity to emotions
+
Invalidating and/or ineffective environment in childhood
+/-
Traumatic event(s) throughout lifespan
=
Higher difficulty regulating emotions, higher frequency of difficult emotions, higher intensity of emotions, high reactivity, slow return to baseline
A consequence of prolonged dietary restriction that contributes to constipation.
Delayed gastric emptying or Gastroparesis
DEAR MAN GIVE FAST
Describe
Express
Assert
Reinforce
(be) Mindful
Appear confident
Negotiate
(be) Gentle
(act/be) Interested
Validate
Easy Manner
(be) Fair
(no) Apologies
Stick to values
(be) Truthful
Name an opposite action to unjust guilt.
Several possible answers, including self-love, encouragement, and rewarding yourself.