DBT basic principles

Question 1

Fundamental dialectic:

Answer 1

acceptance vs. change

Question 2

5 common factors for therapies for BPD

Answer 2

• clear treatment framework
• attention to affect
• focus on the therapeutic alliance
• active/directive therapist
• exploratory and change-oriented

Question 3

five essential functions of DBT

Answer 3

• increase motivation
• teach skills
• generalize skills to environment
• enhance therapist motivation/skills
• structure program/environment

Question 4

dialectics in DBT

Answer 4

synthesis of opposites; truth is contextual

Question 5

nine fundamental dialectics:

Answer 5

• acceptance v. change
• caring v. accountability
• emotion v. reason
• doing your best v. doing better
• client-directed v. therapist-directed
• sitting with v. problem-solving
• intervene v. consult
• availability v. limits
• help-seeking v. self-efficacy
• other-focused v. self-focused

Question 6

four core DBT assumptions of clients:

Answer 6

• clients do their best and can do better
• clients can’t fail therapy but therapy can fail them
• clients want to improve but need skills to do so
• skills need to generalize to all areas of life

Question 7

dialectical abstinence

Answer 7

not using dialectics with extremely negative behaviors (e.g., suicidal behavior, etc.)

Question 8

abstinence violation effect

Answer 8

tendency to go to extremes once a boundary is crossed

Question 9

core DBT assumptions of therapists:

Answer 9

• therapists practice the core conditions (empathy, congruence, positive regard)
• therapists are unrelenting in approach but strengths-based
• therapists use consultation
• therapists practice skills
• therapists favor consultation to intervening

Question 10

core DBT assumptions of treatment:

Answer 10

• treatment is non-judgmental and accountable

- behavior that doesn’t work in life should not be reinforced in session; behaviors that work should be reinforced

Question 11

DBT biosocial theory

Answer 11

emotional dysregulation/vulnerability interacting with invalidating social environments drives dysfunction

Question 12

three components of emotional dysregulation:

Answer 12

• emotional sensitivity
• emotional reactivity
• slow return to baseline

Question 13

kindling effect

Answer 13

frequent emotional reactions lead to greater emotional reactivity

Question 14

three common types of invalidation

Answer 14

• abuse/neglect
• verbal invalidation (rejection, pathologizing)
• unrealistic expectations

Question 15

validation is a primary intervention to:

Answer 15

• reduce acute emotions
• exposure to emotions
• corrective validating environment
• creates bridge to self-validation
• opens up client to change techniques

Question 16

emotion regulation taught to:

Answer 16

• identify emotions
• reduce emotional vulnerability
• create positive emotions
• help change ineffective mood-congruent behaviors

Question 17

mindfulness taught to:

Answer 17

• reduce amplifying emotions
• reduce escape and avoidance
• create qualitatively different and effective experience of emotions

Question 18

distress tolerance taught to:

Answer 18

provide healthy ways of coping with emotions

Question 19

radically open DBT

Answer 19

-some people have emotional regulation issues related to over-regulation

Question 20

stage 1 treatment targets:

Answer 20

1: reduce life-threatening behavior
2: reduce therapy-interfering behavior
3: reduce quality of life decreasing behavior
4: increase skill use

Question 21

stage 1 goals:

Answer 21

stability and behavioral control

Question 22

stage 2 goals:

Answer 22

work on trauma, increase stability

Question 23

stage 3 goals:

Answer 23

increase self-respect/competence

Question 24

stage 4 goals:

Answer 24

self-actualize

Question 25

treatment hierarchy:

Answer 25

1: suicidal behaviors
2: self-injurious behaviors
3: treatment-interfering behaviors
4: quality of life interfering behaviors