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20 Cards in this Set

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What is the overall goal in DBT

Increasing Dialectical Behavior patterns
Universalistic thinking vs relativistic thinking


Two poles of a dialectic:


assumption of fixed, universal truths and order vs


no universal truth and order depends on who is doing the ordering


Problematic thinking patterns in dbt


1. conclusions based on insufficient info


2. overgeneralizations.


3. inappropriate attirubtion of blame and responsibility for negative events to others.


4. or to self


5. exaggerating the significance of events.


6. name calling


7. catastophizing


8. hopeless expectancies

Suicide Crisis behavior


Stage 1 Target


behaviors that convince the therapist the client is at high risk for suicide.

Parasuicidal (NSSIB) acts


Stage 1 Target


if have nssib 2x more likely to suicide


is a bx that is incompatible with every goal of every treatment


insisting on stopping communicates therapist cares.


Suicidal Ideation and Communication


a Stage1 Target


goal is to dec frequency and intensity


only targeted when it is new or unexpected, is intense or aversive


target when associated with nssib, suicide criss bx or interferes with skillful problem solving


Suicide related Expectancies and Beliefs

a Stage 1 target


the client's expectations about long term, not short term consequences are addressed only if they connect to nssib, suicide crisis bx or interfere with skillful problem solving


Suicide Related Affect


a Stage 1 target


as with others, only target if connects to nssib, suicide crisis bx or interferes with skillful problem solving.


watch for conditioned release that is paired with stage 1 targets

Second Target in DBT...

Decreasing therapy interfering behaviors

Categories of Therapy interfering bx

1) any bx that get in the way of tx being offered.




2) bx that interfere with pt.s benefitting from tx.




3) bx that burns out the therapist.

Behaviors that interfere with receiving therapy

a TIB


categories include:


Nonattentive behaviors


non collaborative behaviors


non compliant behaviors





Categories of behaviors that burn out therapists

pushing the therapists personal limits


bx that push the organizations limit


bx that decrease the therapist's motivation


bx that reduces other member's motivation

Therapy Enhancing behaviors of pt

1) make progress in treatment


2) interact with therapist in a way that makes therapist want to continue working together

Categories of TIB of therapist

1) balance within the therapy delivery




2) respect for the pt.

TIB that create therapeutic Imbalance

1) imbalance of change vs. acceptance


2) imbalance of flexibility vs stability


3) imbalance of nurturing vs demanding change


4) imbalance of reciprocal vs irreverent communication



Distress Tolerance change skills

ACCEPTS


Self Soothe


Improve


pros cons

Distress Tolerance Accept skills

Radical acceptance


turning the mind


willingness vs willfulnes

Steps to emtion regulation

1. ID and label affect -- what is that emotions?


2. ID obstacle to change - what reinforces this emotion?


3. reduce your vulnerability to emotion mind


4. increase positive emotional events.


5. increase mindfulness to current emotion


6. take opposite action


7. apply distress tolerance when needed

self management skills

what is needed to learn, maintain and genearlzie new behaviors and to inhibit/ extinguish undesirable bx.



categories of self management skills

1. understanding principles of bx change.


2. realistic goal setting


3. environmental / behavioral analysis skills


4. contingency management skills


5. environmental control techniques


6. relapse prevention plans


7. ability to tolerate limited progress