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Jasmine Jenkins, PhD
What is D.B.T.?
DBT is a modified and more comprehensive branch of Cognitive Behavioral Therapy that utilizes individual treatment and skills training to help people cope with difficult emotions and create behavioral change.
Introduction
What is a dialectic?
The concept that two things can be true at the same time. The major dialectic in DBT is Acceptance and Change.
We must accept residents for who they are in every moment AND challenge them to change disruptive behaviors.
(1) Individual therapy
(2) Weekly DBT groups/skills training
(3) Counselor consultation team meetings
(4) Clients have access to phone coaching/counselor request
FULL
DBT
1. Mindfulness
Intentionally focusing on the present moment, without judgment.
2. Distress Tolerance
These skills help individuals cope during stressful situations. They help tolerate emotional and physical pain.
4 Modules
3. Emotion Regulation
These skills help individuals learn the main 10 emotions, understand emotions, and control/change emotions.
3. Emotion Regulation
These skills help individuals learn the main 10 emotions, understand emotions, and control/change emotions.
4. Interpersonal Effectiveness
These skills help individuals build healthy relationships, develop self-love/self-respect, and ask for what you want/need from others .
Marsha
Linenhan &
BPD
What
Skills
Mindfulness Activity
Mindfulness
What
Skills
Explain what you are doing
when practicing mindfulness
Explain how to practice mindfulness
How
Skills
Wise Mind = Values both emotion and reason when making decisions or prior to
reacting to triggers.
Wise Mind
Reasonable mind=
Rational, task focused, & evaluates facts. Feelings are not important.
Emotion mind =
Focused on mood, feelings, and action urges. Facts and logic are not important.
middle path.
Distress
Tolerance
Check the Facts
10 EMOTIONS
Happy
Sad
Angry/Mad
Fear
Shame
Guilt
Jealousy
Envy
Love
Disgust
Emotion
Regulation
Step 1. What emotion do you have?
Step 2. What is causing this emotion? JUST FACTS
Step 3. What are my thoughts/interpretations/OPINIONS? Separate those from the facts
Step 4. Does your emotion (step 1) fit the FACTS (step 2)? aka. Does it make sense to have this emotion?
Opposite Action
Problem
Solving
ABC PLEASE
ABC
PLEASE
Accumulate Positives
Build Mastery
Cope Ahead situations
(Treat) Physical Illness
(Balanced) Eating
(avoid) mood Altering substances
(Balanced) Sleep
(Get) Exercise
Interpersonal
Effectiveness
Diary Cards
Diary cards provide the clinician with an overview of daily urges, behaviors, emotions, and skills used by residents.
Chain Analysis
A chain analysis is used by counselors to help residents discuss the triggers/prompting events that led to problem behaviors (fights, disrespect, self-harm, etc.), evaluate the emotions and thoughts that proceed and follow the behaviors, discuss the consequences of problem behaviors, and think about alternative behaviors/skills that could replace the problem behaviors.
Individual
Treatment
Thinking Mistakes
Thinking Mistakes are the DBT version of Thinking Errors which are CBT cognitive distortions .
Phone Coaching
Phone coaching provides individuals with access to brief check-ins with their counselor between sessions IF needed.
Diary Cards
DBT handouts
Chain
Analysis
Thinking Errors vs.
Thinking Mistakes
Thinking
Mistakes
Phone
Coaching
Case
Scenario
-Take notes on the case described
-Break into groups and identify
(1) Skills this client will need?
(2) When should chain analysis be utilized with this client?
(3) Biggest challenges?
(4) Any other treatments that may be helpful?
Thank you!