DBT (Feinstein)

Question 1

5 functions

Answer 1

1 improve clients motivation to change
2 enhance clients capabilities
3 facilitate generalization
4 enhance therapists motivation
5 help structure the environment

Question 2

5 Models of DBT

Answer 2

1. Skills group: Enhance capabilities
2. Phone coaching: Enhance generalisability
3. Case management: Structure environment
4. Consultation team: Enhance therapists motivation
5. Individual therapy: Enhance motivation

Question 3

Phone coaching

Answer 3

Not ment for crisis, only to help generalizability and in vivo exposure.

Clients are meant to call before crisis, to discuss strategies

No reinforcing crisis behaviour by responding quicker/warmer. After crisis call is made: 24hr no phone. Meant to make relationship predictable and not reinforce that behaviour. Do make plan beforehand for 24 hr period

Question 4

Three central principles

Answer 4

Wholeness: entirety of a situation over the individual parts. Transaction between person/environment

Polarity: Reality is never perfectly balanced. Bad behaviours have a function

Continuous change: accepting constant change and harnessing it to move toward life worth living

Question 5

Chain analysis

Answer 5

Helps detect patterns and sequences that lead to problematic behaviour

Problem is identified w eg diary card, and therapist guide through chain analysis: What chain led to X and Why did elements of that chain to the next. (very specificly)

Question 6

Limitations of DBT

Answer 6

Very expensive and extensive

Often agencies don’t reimburse skill groups, half treatment decreases outcome

DBT requires a lot of learning, can be hard with SU

Overall, one of the most well-researched therapies with empirical evidence. Very successful but more research is needed in cultural diff., children, multi-diagnostic and which elements are crucial.