Dialectical Behavioural Therapy Lecture

Question 1

What is dialectical behavioural therapy for?

Answer 1

• Patients with emotionally unstable personality disorder
• Full DBT programme (18 months, groups and individual sessions, 24/7 support)
• Full DBT not available in Leicester but do offer DBT skills

Question 2

Key elements of borderline / EUPD

Answer 2

• Emotional dysregulation
• Impulsivity –> self harm, suicide
• Interpersonal sensitivity/fear of abandoment
• Attachment and developmental trauma is internalised and repeated in adult life
• Impaired sense of self

Question 3

What does DBT do?

Answer 3

• Dialectical - establish balance between acceptance and change - accept difficult feelings and distress and how they can change them (do not discredit one part of them)
• Behavioural skills - toolkit eg self soothing box
• There is part of patient who wants help and another part which doesn’t and wants to self harm - need to address both

Question 4

4 main treatment domains of DBT

Answer 4

• Emotional regulation
• Distress tolerance
• Mindfulness - living in present, without judgement, zen buddhist model, observe feelings and say them (box breathing, body scan)
• Interpersonal effectiveness

Question 5

What is distress tolerance?

Answer 5

• Allows person to survive in immediate emotional crisis and to accept reality of situation when they feel out of control
• Help people cope with feelings when they don’t know what to do or need in that moment

Question 6

Distress tolerance techniques - 2 examples

Answer 6

• STOP - Stop don’t react stay in control, Take step back deep breath and don’t act impulsively, Observe emotions, Proceed to planned goal
• 54321 - 5 things can see, 4 things can touch, 3 things can hear, 2 things can smell, 1 thing can taste

Question 7

What is involved in emotional regulation?

Answer 7

ABC PLEASE - encourage recognising emotion too
* Accumulate positive emotions by doing things that are present
* Build mastery by doing things we enjoy
* Cope ahead by rehearsing plan so can be prepared
* Physical illness - treat it timely
* Eating - eat healthy
* Avoid mood altering drugs
* Sleep - balanced, not too much or too little
* Exercise regularly to improve body image and release endorphins

Question 8

Interpersonal effetiveness - what is this?

Answer 8

• Learn to get along with others whilst also asserting your own needs is essential to healthy relationships
• Can be difficult to balance own needs and others
• Need emotional intelligence, communication, leadership, positivity, empathy, teamwork, negotiation, conflict resolution

Question 9

Interpersonal effectivness tool

Answer 9

DEARMAN
* Describe
* Express
* Assert
* Reinforce
* Mindful
* Assertive
* Negotiate