1、1Dialectical Behavior Therapy:An Introduction to the Philosophy and SkillsJancey Wickstrom,AM,LCSWTweet us at#NASWIL2Overview Philosophy based treatment Overall goal:creating a meaningful life Skills are easily adaptable to variety of situations,abilities,and interests Helps a wide range of behavior
2、s intended to regulate emotionTweet us at#NASWIL3Dialectics Middle ground From either/or to both/and Black or White thinking to Black AND White thinking Emerged from repeated ineffective interventions Counteracts rigidityTweet us at#NASWIL4Dialectic of DBT Acceptance Mindfulness Distress tolerance C
3、hange Emotion regulation Interpersonal effectivenessTweet us at#NASWIL5DBT Framework Four components:Skills trainingIndividual therapy Telephone consultation Consultation groupTweet us at#NASWIL6Consultation Agreements Dialectical Agreement Consultation to the Client Agreement Consistency Agreement
4、Observing Limits Agreement Phenomenological Empathy Agreement Fallibility Agreement7Assumptions in DBT Clients are doing the best they can Clients want to improve Clients must do better,try harder and be more motivated to change Clients may not have caused their own problems but must solve them anyw
5、ayTweet us at#NASWIL8Assumptions in DBT(cont.)Clients lives are unbearable as they currently live Clients must learn new behaviors in all relevant contexts Clients cannot fail in therapy Therapists need supportTweet us at#NASWIL9DBT Principles People with problems regulating emotion have:High sensit
6、ivity High reactivity Slow return to baseline Generally raised in invalidating environments.Tweet us at#NASWIL10DBT Principles(cont.)“Problematic”behaviors served a purpose at one point,but are now ineffective.Clients reward us for reinforcing old ways of living and punish us for doing DBT effective
7、ly.Only way to realize meaningful life is through practice and more practice.Tweet us at#NASWIL11Acceptance:Mindfulness Becoming aware of and present with our thoughts and emotions Differentiating ourselves from our thoughts and emotions-getting“unfused”Practicing controlling our attention NEVER abo
8、ut controlling our thoughts-underlies every single aspect of DBTTweet us at#NASWIL12Learning how to control your mind/attention so it does not control you.MINDFULNESS13Acceptance:Distress Tolerance Skills to help get through a crisis situation without making matters worse Not intended to help client
9、s feel better Anything can help tolerate the moment Willingness vs.Willfulness Mindfulness:practice going back and back and back to skill being usedTweet us at#NASWIL14Getting through the moment without making matters worse.DISTRESS TOLERANCE15Change:Emotion Regulation Change our reaction to our emo
10、tions NOT changing/controlling emotions Learn to identify and use emotions as allies not enemies Mindfulness:Very skilled at distancing from emotions,must slow down and practice this skillTweet us at#NASWIL16Not about changing or controlling our emotions-instead is about changing our reactions to em
11、otionsEMOTION REGULATION17Change:Interpersonal Effectiveness How to get along with others more effectively Helping clients get their needs met(make requests and say no)in a way respectful to both self and others“Manipulation”Mindfulness:being aware of reactions to others as well as what goals areTwe
12、et us at#NASWIL18Getting our needs met while respecting both ourselves and others.INTERPERSONAL EFFECTIVENESS19Questions20Other Useful Resources Mindfulness resources:Jon Kabat-Zinn;Sharon Salzberg;Pema Chodron;Tich Nhat Hahn Dialectical Behavior Therapy Skills Workbook:Practical DBT Exercises for L
13、earning Mindfulness,Interpersonal Effectiveness,Emotion Regulation,&Distress Tolerance(New Harbinger).McKay,Wood,Brantley(also available in teen version)21References Linehan,M.M.(1993).Cognitive-behavioral treatment of borderline personality disorder.New York,NY:Guilford Press.Linehan,M.M.(1993).Ski
14、lls training manual for treating borderline personality disorder.New York,NY:Guilford Press.Holmes,Paul.Contextual behavioral approaches,personal communication.Emotion Management Program,Orland Park,IL.22Other Useful Resources Learning to Breathe:A Mindfulness Curriculum for Adolescents to Cultivate Emotion Regulation,Attention,and Performance.Patricia Broderick Dont Let Your Emotions Run Your Life:How Dialectical Behavior Therapy Can Put You in Control(New Harbinger).Spradlin(also available in teen version)23Thank you!Jancey Wickstrom,AM,LCSWJTweet us at#NASWIL
