overview of dbt
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Overview of DBTTRANSCRIPT
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Overview of Dialectical
Behavior Therapy
Skill Generalization as a
Strong Mechanism to
Change
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Therapy
Real life
Change outside
the Therapy
Session
Change in the
Therapy
session
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What Happens in DBT?
• Commitment
• Dialectical process of change
• Problem solving
• Acceptance
• Validation
• Mindfulness, InterpersonalEffectiveness, EmotionRegulation, Distress toleranceskills
• Chain analysis
• Insight
• Discrimination training
• Expanding behavioral repertoires• Stimulus control
• Contingency management
• Contingency clarification
• Cognitive modification
• Dialectical strategies
• Irreverence/warmth
• Relentless/Caring Staff &Therapist
• Radically genuine Staff&Therapists
• Compassion and non-judgment• Hope
• Persons “start stopping” in theirlife
• Speed, movement, & flow
• Unpredictability of the World
• Responding differently than othertherapists & staff have
• Exposure, response prevention,opposite action to urges
• Tolerance for aversive states
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So, What Really Happens in DBT?
A whole lot of learning
Adapted to thePerson’s Capability
and Learning Style!
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Skills
Newly learned behavior that is likely to
be effective = skills
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Targeting Behavioral Change
Across the DBT Program
• Skillful behavior occurs during group and
individual therapy sessions
– Mindfulness, emotion regulation, interpersonal
effectiveness, and distress tolerance skills
– Problem-solving
– Validation
– Acceptance
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Targeting Behavioral Change
Outside the Session
• OK, so the skillful behaviors have been
acquired, but now what?
• Wait and hope?
• I don’t think so….
• Goal is skill transfer into all relevantcontexts
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Targeting Behavioral Change
Outside the Session
• Consulting with the individual to improve
interpersonal relationships and solve
problems
• Problem-solving environmental barriers
• Self-monitoring
• Therapy homework• Willingness to intervene in the
environment if needed
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Principles DBT
(1) Exploit current
functional
contingencies
DBT therapists & staff use praise and
warmth to reinforce occurrences of skill use
that are recorded naturalistically;
Individuals are taught to use skills in
contexts that will reinforce the use of skills (e.g., with supportive significant others)
(2) Train diversely
EVERYONE learns
DBT
DBT therapists & staff attempt to increase
the use of skills across a wide array of
relevant contexts
(3) Incorporate
functional mediators
DBT therapists & staff are paired with skill
acquisition in treatment sessions; Diary
card, audiotapes, telephone etc. All are
factors that can function to evoke skills
previously learned in the therapy setting
Principles of Skill Transfer (Stokes
and Osnes, 1989) and DBT
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Generalization/Skill Transfer in
DBT
• Functional mediators (e.g., diary card, phone,physical reminders of sessions) are used
• However, one size does not fit all when it comes
to generalization….• So, solution analyses are critical when planning
for skill generalization
• Solution analyses promote the personalized
application of functional mediators (e.g., how willTHIS way of transferring skills work THIS weekfor YOU? Why won’t it work?)
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Skill Transfer Technology
Simple Complex
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Skill Transfer as a PossibleMechanism of Change…. is
DBT!
Questions