DBT

Question 1

Steps for radical acceptance

Answer 1

1. Recognize you are resisting reality (willfull; “it’s not fair, etc”; “what if this is as good as it gets”)
2. Acknowledge the facts of reality and that it cannot be changed (“this is what happened”)
3. Acknowledge the reasons for reality (“this is how it happened”; everything has a cause / is linked)
4. Make the choice to accept reality (turning the mind towards willingness)
5. Practice accepting reality
   - Willing hands / half-smile
   - List what would you do if you were to practice reality –> do it (opposite action)
   - Relaxation skills
   - Accepting self-talk, prayer, imagery
6. Allow sadness/grief/disappointment to come/go

Pros/cons if get stuck

Question 2

What is DBT (short answer)

Answer 2

Type of integrative psychotherapy (CBT)

(designed by Marsha Linehan)

that combines CBT + mindfulness
(+ other skills incl emotion regulation, distress tolerance, interpersonal effectiveness)

(to target SI/SH behaviours + emotional dysregulation in borderline PD)

Question 3

DBT created by

Answer 3

Marsha Linehan

Question 4

Original purpose of DBT

Answer 4

Decrease SI/SH behaviours + emotional dysregulation in borderline PD

(But balance it with acceptance)

Question 5

What does dialectical mean

Answer 5

Finding balance and truth in opposite perspectives/experiences

Question 6

Stepwise targets for DBT

Answer 6

1. Life-interfering behaviours (self-harm/suicidal behaviours)
2. Therapy-interfering behaviours (maintain engagement)
3. QOL-interfering behaviours (impulsivity)
4. Build a life worth living

Question 7

Phases of DBT

Answer 7

Phase 1 (acquire skills, stabilization of life/therapy/QOL interfering behaviours)
Phase 2 (practice sitting with emotions + address problems perpetuating trauma, invalidation, betrayal)
Phase 3 (fine-tuning)

Question 8

Phase 1 DBT

Answer 8

Acquire skills, stabilization of life/therapy/QOL interfering behaviours

Question 9

Phase 2 DBT

Answer 9

Practice sitting w/ emotions + address problems perpetuating trauma, invalidation, betrayal

Question 10

Overall structure of DBT

Answer 10

Skills group training
Individual psychotherapy
Telephone coaching
Therapist consultation group

Question 11

Skill sets in DBT

Answer 11

Mindfulness
Emotion regulation
Distress tolerance
Interpersonal effectiveness

Question 12

Structure of individual DBT sessions

Answer 12

Set agenda 
Review diary card
\+/- behavioural chain analysis 
Problem solving/analysis + coaching use of skills
Validate throughout entire process

Question 13

Acceptance skills in DBT

Answer 13

Mindfulness

Distress tolerance

Question 14

Change skills in DBT

Answer 14

Emotion regulation

Interpersonal effectiveness

Question 15

Purpose of telephone coaching in DBT

Answer 15

Help you use (generalize use) of skills
when feeling SI/SH
but not able to use skills on own
(not for when you’ve already self-harmed)

Question 16

Steps in telephone coaching in DBT

Answer 16

ID problem
Validate
ID goals
Contract to safety (or call 911 / pt to go to and call from ER)
Develop action plan to use acceptance skills

Question 17

Rating scale for borderline PD

Answer 17

BEST (borderline evaluation of severity over time; can complete at each group skills training)