Dialectical Behavior Therapy Case Study

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Dialectical Behavior Therapy (DBT) is a Third Wave Therapy created by Marsha Linehan in the 1970’s. It is derived from a cognitive behavioral perspective. In high school Linehan wanted to become a psychiatrist and work with the most mentally disturbed patients. She realized, however, that there weren’t a lot of effective treatments for these patients. She then decided to earn a PhD in experiential personality psychology (Prochaska & Norcross 2014).
Linehan wanted to work with the most difficult patients, but she realized they often were not willing to participate. She theorized that comprehensive psychotherapy should meet the following five vital functions:
“1. Enhance and maintain the client’s motivation to change
2. Enhance the client’s
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Rather than trying to change troubling incidents and situations, this skill teaches how to skillfully tolerate pain in a difficult circumstances. It helps clients become strong by learning techniques that soften the effect of upsetting situations. “Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness” (An overview, 2015).
The third is interpersonal effectiveness, which keeps relationships healthy by learning and practicing social-skills training, assertiveness training, listening skills and negotiation skills. (McKay et al, 2007, p. 183). Patients learn to ask for what they need, express beliefs and needs, say “no” while at the same time maintaining self-respect, set limits, and have good relationships with others through managing interpersonal conflicts (An overview,
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The first is group sessions that are held each a week for two and a half hours. The session is taught like a class where the group leader teaches specific skills and assigns homework. The full skills curriculum takes twenty-four weeks and is sometimes repeated to last a full year. The second component is individual sessions. Here the therapist and client meet together once a week. The therapist and client work together to enhance motivation for the program and discuss how to apply skills learned in the group to specific challenges and events in the client’s life. The third component is phone coaching. If a difficult situation arises in the client’s life, he or she can call the therapist and receive in-the-moment coaching on skills for specific experiences and challenges in his or her life. Last of all is the DBT therapist consultation team, which consists of therapists and group leaders. Since DBT therapists work with severe and difficult disorders, the team provides support and counsel to each therapist to keep them motivated and competent. They usually meet once a week (What is DBT?

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