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Dialectic Behavioral Therapy for Conduct Disorder

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Karalynn Roll

on 6 December 2014

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Transcript of Dialectic Behavioral Therapy for Conduct Disorder

Homework
For next session, I would like for you all to come prepared with your favorite song. In addition, I would like for you all to practice using your healthy distress tolerance skills.
DBT: Distress Tolerance Toolkit
Now, we are going to use this time to "create" our own toolbox to use in times of crisis.


References
What is Dialectical Behavioral Therapy?
Marsha Linehan developed DBT in the 1970’s when her and her team realized that CBT was not enough alone to meet the needs of those diagnosed with borderline personality disorder (Linehan, n.d.).

By this time, the DBT basics have been covered. This session will use what is called lyric analysis. Lyrics will be passed out to the group and the song will be played. Then, the group will discuss the song using the DBT skill wise mind ACCEPTS (Dietz, 2012).
What is Conduct Disorder?
1. Mindfulness
2. Emotion Regulation
3. Interpersonal Effectiveness
4. Distress Tolerance
(Dietz, 2012)

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author
Borchard, T. J. (n.d.). What is Dialectical Behavioral Therapy? Retrieved from http://psychcentral.com/blog/archives/2011/06/28/marsha-linehan-what-is-dialectical-behavioral-therapy-dbt/
Dietz, L. (2012). DBT skills list. Retrieved from http://www.dbtselfhelp.com/html/dbt_skills_list.html
Linehan, M. M. (n.d.). Marsha M. Linehan, Ph.D., ABPP. Retrieved from http://blogs.uw.edu/linehan/
Mental Health America (n.d.). Conduct Disorder. Retrieved from http://www.mentalhealthamerica.net/conditions/conduct-disorder
Psychotherapy.net (n.d.). Dialectical Behavioral Therapy. Retrieved from https://www.psychotherapy.net/video/dialectical-behavior-therapy-linehan
Read, K. (2013). Dialectical behavioral therapy. Retrieved from http://en.wikipedia.org/wiki/Dialectical_behavior_therapy
The Linehan Institute Behavioral Tech, (n.d.). What is DBT? Retrieved from behavioraltech.org/resources/whatisdbt.cfzm



Dialectic Behavioral Therapy for Conduct Disorder
DBT Modules:
Role Play: What to Expect
The Session
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of 15 criteria in the past 12 months from any of four categories, with at least one present in the last six months (American Psychiatric Association, 2013).


Often bullies, threatens, or intimidates others
Often initiates physical fights
Has used a weapon that can cause serious physical harm to others
Has been physically cruel to people
Has been physically cruel to animals
Has stolen while confronting a victim
Has forced someone into sexual activity
(American Psychiatric Association, 2013)
Aggression to People and Animals
Destruction of Property

Has deliberately engaged in fire setting with the intention of causing serious damage
Has deliberately destroyed others’ property

(American Psychiatric Association, 2013)
Deceitfulness or Theft

Has broken into someone else’s house, building, or car
Often lies to obtain goods or favors or to avoid obligations (ie. cons others)
Has stolen items of nontrivial value without confronting a victim

Serious Violation of Rules
Often stays out at night despite parental prohibitions, beginning before age 13 years
Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period.
Is often truant from school, beginning before age 13 years
(American Psychiatric Association, 2013)
WISE MIND
ACCEPTS
Activities
Contributing
Comparisons
opposite to Emotion
Pushing away
Thoughts
Sensations
Research
Research
More common among boys (6-16%) than girls (2-9%)
Can be early onset (<10) or in adolescence
More common among children of adults who exhibit behaviors
Co-morbidity with ADD, ODD, & later Antisocial Personality Disorder

(Mental Health America, n.d.)
Research suggests Genetic & Environmental Factors
Deficits in processing social information or social cues
Rejection by peers as young children
Integrative, holistic fashion of treatment required for co-occurring emotional and behavioral disorders

(Mental Health America, n.d.)
Main goal: Teach the individual to cope with stress through
1. Regulation
2. Emotions
3. Improving relationships with others.

This is done by using radical acceptance, which is a creating a balance between acceptance and change.

DBT Continued
Individual and group therapy, coaching and collateral contact between sessions, and group supervision and support for the therapist.

4 treatments techniques:
1. Emotional self-regulation
2. Cognitive Behavioral Therapy
3. Assertiveness Training
4. Eastern meditative traditions, such as Buddhist mindfulness meditation.

Modalities
Strategies
1. Skills Training
2. Exposure Therapy
3. Cognitive Therapy
4. Contingency Management
Additional DBT Tools
1. Diary Cards
2. Chain analysis
3. Milieu

DBT Acronyms
1. DEAR MAN
2. ACCEPTS
3. GIVE
4. FAST
(American Psychiatric Association, 2013)
Full transcript