DBT Treatment Stages and Primary Treatment Targets

Question 1

Pretreatment stage:

Orientation and commitment to treatment,

Agreement on goals

Answer 1

Inform and Orient adolescent and family to DBT

Secure adolescent’s, family and therapist’s commitment treatment

Question 2

Stage 1:

Obtaining basic capacities

Increasing safety

Reducing behavioral risk

Answer 2

Decrease life-threatening behaviors

Decrease therapy interfering behaviors

Decrease quality of life interfering behaviors

Increase behavioral skills

Increase skill acquisition, strengthening, and generalization (see 5 core skills card)

Question 3

Stage 2

Answer 3

Decrease avoidance of emotional experience and post traumatic stress

Question 4

Stage 3

Answer 4

Increase respect for self

Achieve individual goals

Question 5

Stage 4

Answer 5

Resolve a sense of incompleteness

Find freedom and joy

Question 6

Mindfulness Skills

Answer 6

Being present in the moment and understand the signs of unregulated emotions

Question 7

Emotion Regulation Skills

Answer 7

Coping with difficult situations

Large focus on physical health:

• Eating properly
• Getting enough sleep
• Taking medication
• Avoiding drug use

Question 8

Interpersonal Effectiveness Skills: DEARMAN

Answer 8

Interactions with others are often negative triggers for impulsive behaviors

The purpose is to teach adolescents how to interact more effectively with others, and enable them to feel more supported by others.

“D.E.A.R.M.A.N.”
Describe–stick to the facts

Express–“I” statements, stay away from “you should”

Assert–ask for what you want or say “no” clearly, no mind reading

Reinforce–reinforce the person ahead of time by explaining the positive effect of getting what you want

Mindful–ignore attacks, focus on what you want,

Appear Confident–eye contact, confident tone, no whispering/mumbling

Negotiate–be willing to give to get, ask for input, offer alternative solutions; know when to agree to disagree and walk away

Question 9

Distress Tolerance Skills

Answer 9

The ability to recognize urges such as self-harm and suicide, and consciously control them

Question 10

Walking the Middle Path Skill

Answer 10

Kids and parents learn how to validate one another

How to compromise and negotiate

How to see the other person side of things

More about acknowledging multiple truths in the teenagers’ and the parents’ worldview as opposed to
“I’m right and you’re wrong”

Question 11

5 Core Skills

Answer 11

Mindfulness

Interpersonal effectiveness

Emotion regulation

Distress tolerance

Walking the middle path