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Foundations of DBT Flashcards

1
Q

DBT is a _-based treatment that incorporates _ as needed (e.g., exposure and response prevention; behavioral activation)

A

Principles; Protocols

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2
Q

DBT assumes that borderline personality disorder is primarily a dysfunction of ________________

A

Emotion Regulation

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3
Q

DBT assumes that

A

Clients are doing the best they can

Clients want to improve

Clients need to do better, try harder, and be more motivated to change

Clients may not have caused all of their own problems, but they have to solve them anyway

New behaviour has to be learned in all relevant contexts

All behaviours (actions, thoughts, emotions) are caused

Figuring out and changing the causes of behaviour is a more effective way to change than judging and blaming

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4
Q

The most fundamental dialectic within DBT is the attempt to balance ___________ with ____________.

A

Acceptance and Change

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5
Q

The main purpose of the DBT consultation team is to:

A

Increase therapists’ motivation and capabilities to deliver DBT.

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6
Q

What are all of the functions of the observer in a DBT Consultation Team meeting?

A

Highlighting the dialectical tensions that arise in the team

Describing polarization when it occurs

Identifying judgmental, non-empathic statements

Describing when members are doing more than one thing in the moment

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7
Q

Which of the following are the ways in which behavioural science is incorporated into DBT?

A

The use of scientific method in treatment development

The use of scientific method in the manner in which treatment is conducted

Reliance on observation

The procedures of behaviour therapy

Reliance on evidence

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8
Q

Why is it important to understand the research on DBT?

A

To provide hope to clients and families.

To determine whether DBT will be effective for a particular client.

To be reimbursed for your services by payors like insurance companies

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9
Q

According to research on DBT,

A

DBT is effective for problems other than suicide and self-harm.

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10
Q

Which of the following is an acceptance principle in DBT?

A

All things are perfect as they are

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11
Q

Zen is compatible with behavioural science because both:

A

Rely on observation.

Emphasize describing without interpretation.

Stress that acting “as if” helps to increase capabilities.

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12
Q

Which of the following represents the dialectical worldview of DBT regarding traditional conceptions of “truth”?

A

There is no absolute truth, nor is truth relative

Truth evolves over time and in context

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13
Q

When polarization occurs, it is important to search for what?

A

Synthesis

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14
Q

In teaching dialectical reasoning, the therapist helps the client move from “either-or” statements or thinking to “___________________” statements, thus communicating to the client that opposite statements are possible.

A

both-and

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15
Q

In DBT the core set of change strategies are ____________. These strategies are balanced by ______________.

A

Problem Solving; Validation

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16
Q

Which of the following are goals of mindfulness in DBT?

A

To reduce suffering

To increase control of one’s mind

To experience reality as is

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17
Q

Which of the following is the most accurate statement about Wise Mind?

A

All people, including clients with the greatest difficulties, have inherent wisdom

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18
Q

The core mindfulness “What” skills include

A

Observe, Describe, Participate

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19
Q

The core mindfulness “How” skills include

A

Non-Judgementally, One-Mindfully, Effectively

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20
Q

Which of the following is INCORRECT regarding the practice of mindful observing in DBT?

A

Putting words on an experience

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21
Q

According to the DBT model, self-harm can best be conceptualized as

A

Maladaptive Problem Solving

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22
Q

The Biosocial Model posits that BPD/pervasive emotion dysregulation results from a(n) _ of _ and a(n) _.

A

Transaction; Emotion Vulnerability; Invalidating Environment

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23
Q

Which of the following characterizes high emotional vulnerability?

A

High sensitivity to emotions
High reactivity to emotions
A slow return to baseline

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24
Q

What is the best definition of an “invalidating environment?”

A

One that dismisses or rejects behaviour regardless of its validity

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25
Clients with borderline personality disorder present a variety of 'dialectical dilemmas' for the clinician to address. What are they?
Emotional Vulnerability; Self-Invalidation Unrelenting Crisis; Inhibited Grief Active Passivity; Apparent Competence
26
What of the following are a function of emotions?
To motivate the organize for action To communicate to and influence others To communicate to ourselves
27
Opposite action can be used in which of the following situations:
When an emotion is unjustified and acting on the emotion is ineffective When an emotion is justified and acting on the emotion is ineffective
28
In the DBT Emotion Regulation skills, ABC stands for
Accumulating Positives, Building Mastery, Cope Ahead
29
What is the primary function of the individual therapy mode of DBT in Stage 1?
Improve client motivation
30
What is the primary function of DBT skills training?
To enhance client capabilities
31
What is the primary function of telephone coaching in DBT?
To increase generalization of skills to the natural environment
32
Which of the following statements is accurate in regards to level of disorder and stages of treatment?
Stage of treatment is dependant upon a client's level of disorder
33
What is the correct order of targets for an individual DBT session with a stage 1 client?
Decrease life-threatening behaviour, decrease therapy-interfering behaviour, decrease quality-of-life interfering behavior, increase behavioral skills
34
Which approach to post traumatic stress disorder (PTSD) is consistent with a DBT approach?
A DBT therapist does not focus directly on traumatic stress until previous target behaviors are under control but helps clients with skills to manage traumatic stress until PTSD can be formally targeted.
35
What is the highest priority target for DBT Skills Training?
Decrease behaviours that destroy therapy.
36
Which of the following is a Stage 2 target of treatment?
Experiential avoidance
37
If a client who is in both individual therapy and skills training class needs help in applying behavioral skills to everyday life, the client is directed to first call
The individual therapist
38
Which of the following are primary treatment targets for individual therapy in Stage 1 DBT?
Therapy Interfering Behaviour Quality of Life Interfering Behaviour Life Threatening Behaviour
39
What are the goals of DBT pretreatment?
Determine whether DBT is an appropriate treatment for the client Determine whether you are willing to provide DBT to the client Obtaining commitment
40
With a client presenting suicidal behaviour, the DBT therapist would:
before beginning treatment, require some type of commitment to staying in therapy (and thus staying alive), working to replace suicidal behaviour with more adaptive ways of coping, and attending skills training.
41
To which of the following must you orient during pre-treatment?
If clients miss either four individual or four skills training sessions in a row, they are out of treatment.
42
In DBT, suicidal clients accepted into treatment must agree to do what, at a minimum?
Reduce suicidal and self-injurious behaviour Make every effort to attend all treatment sessions
43
The devil's advocate technique as a commitment strategy involves
Presenting a weak argument against a commitment so that the client will argue in favour of commitment
44
What is the rationale for the use of diary cards in individual DBT therapy?
To increase accuracy of client recall. To identify patterns of behaviour over time. To structure individual therapy sessions.
45
What is the primary purpose of orienting to skills training?
To “sell” the new skills behaviours as worth learning and likely to work
46
In DBT skills training, which set of skills is repeated at the beginning of every module?
Mindfulness
47
How are suicidal communications and ideation best addressed during skills training?
Help the clients figure out how to apply skills being taught to the suicidal thoughts and feelings. Refer to individual therapist for follow up.
48
Check each of the following factors that may interfere with interpersonal effectiveness.
Being unclear about interpersonal priorities Emotions inhibiting skillful behaviour Others in the environment having more power Thoughts and beliefs Not having the needed skills
49
Which skill set do you want to emphasize when the relationship is the primary goal in an interpersonal interaction?
GIVE (Gentle, Act Interested, Validate, Easy Manner)
50
Which skill set do you want to emphasize when maintaining self-respect is your primary goal in an interpersonal interaction?
FAST (Be Fair, no Apologies, Stick to your Values, Truthful)
51
Which of the following is the most accurate list of distress tolerance skills?
STOP, Pros & Cons, TIP, Distracting
52
What is the primary goal of the crisis survival skills?
To survive a crisis without making the situation worse.
53
What is the TIP skill?
Temperature, Intense Exercise, Paced breathing, Proceed Mindfully
54
Select each of the following that is a step in problem solving.
Check the Facts, Brainstorming, Goal Clarification, Defining the Problem
55
When a DBT therapist is using problem solving strategies, typically they begin by _________________.
Conducting a chain analysis
56
The main goal of a chain analysis in DBT is to:
Analyze the series of events leading to and following a problem behaviour
57
The best strategy for the therapist to employ during a chain analysis is:
to play the role of the naive observer, making no assumptions and taking pains to cover every movement, thought and assumption on the part of the client.
58
When analyzing vulnerabilities in a chain analysis, it is most important to:
Focus on those vulnerabilities that specifically influence the problem behaviour and can be remediated.
59
A missing links analysis should be used
When a desired behaviour did not occur.
60
When performing solution analyses with clients
the therapist can generate more solutions at the beginning of treatment, and offer fewer solutions as treatment progresses.
61
Which of the following is true in terms of DBT’s approach to principles of changing and maintaining behaviour and learning?
DBT teaches clients all principles of changing and maintaining behaviour and learning.
62
The two primary cognitive strategies in DBT are
Contingency clarification and cognitive restructuring
63
DBT utilizes
Both formal and informal exposure strategies
64
Reinforcement is
A consequence that results, on average, in an increase in a behaviour in a particular situation
65
Choose all of the following that can be used to increase a behaviour:
Intermittent reinforcement Negative reinforcement Positive reinforcement Shaping
66
Which of the following is NOT used to determine validity in DBT?
Morality Logical Consistency, Evidence, Long-term goals
67
Invalidation should be avoided at all costs. It is one of the most harmful of human experiences.
False
68
Which of these is NOT an accurate statement of DBT's approach to validation?
You really don't know what's in the mind of another person, and you should not engage in “mind reading” because the risk of error and offence is too great.
69
A client states during the initial session that they fear that the therapist will reject them. Which of the following therapist responses is level 5 validation?
"I understand that you would be concerned. Given that you don’t yet know me and we have not yet covered the treatment guidelines you don't know what to expect!”
70
What can you expect to happen with a previously reinforced behaviour is no longer being reinforced?
a temporary increase in the frequency of the desired behaviour
71
According to the principles of DBT, which of following statements is correct?
If a client expresses something such as an urge to scream or hit the therapist, but does not identify a corresponding emotion, DBT therapists do not assume that the client is experiencing the emotion unconsciously.
72
What is an example of functional validation?
Your client starts to cry and you hand them a tissue.
73
In DBT, metaphors can be used
To help clients remember complex concepts When teaching clients new skills
74
Which of the following is an example of entering the paradox?
“Experiencing painful emotions is required to find relief from emotional suffering”
75
Which of the following is NOT an example of a dialectical strategy?
Push the patient to adopt an opposite position
76
What is "extending" as a dialectical strategy?
Taking clients more seriously than they take themselves
77
The primary function of irreverence is to
Keep the client off balance
78
Which of the following is true of therapist self-disclosure in DBT?
There are no rules about what a therapist may disclose, but disclosure should be in service of the client’s goals.
79
Reciprocal communication strategies include
Warmth, being non-judgmental, responsiveness
80
When assessing suicide risk for your client it is most important to review…
current epidemiological data for your client’s demographics in the client's area
81
Risk factors for suicide typically remain stable for specific populations over time.
False
82
Formal assessment of suicide risk should be conducted
At intake or first session
83
Long-term risk factors for suicide need to be assessed
At an environmental level At the behavioural level At the organismic level
84
DBT posits that suicidal behaviour can be described as _. Therefore, it should be treated by _.
Maladaptive problem solving; improving problem solving behaviour
85
What is the first step in treatment planning with suicidal individuals?
Assess the chronic and acute risk of suicide and deliberate self-harm
86
Which of the following suicidal behaviours must always be targeted in DBT individual therapy sessions?
Significant increase in suicidal or self-injurious urges Non-suicidal self-injury act Suicide preparation (e.g., rehearsal, plans)
87
Your patient tells you in session that they engaged in intentional self-injurious behaviour in the past week but adamantly refuse to tell you what they did to themselves. Should you conduct a chain analysis? If so, how would you proceed?
Yes, it is important to conduct a chain analysis on the problem behaviour, and it may be necessary to assess the client’s refusal to talk first.
88
When should hospitalization be considered?
Suicide threats are operant and hospitalization is aversive
89
The primary function of phone coaching in DBT is
To generalize skills to the client’s environment
90
What is the highest priority target of the individual therapist when doing DBT Phone Coaching?
To decrease suicide crisis behaviours
91
In vivo behavioural rehearsal serves what function:
Practice in new behaviour Generalization to a setting outside the skills training group A fancier, more specific way to say “homework assignment”
92
Case management strategies in DBT are best represented by
Balancing between environmental intervention and consultation to the patient
93
In DBT, the therapist will intervene with other mental health practitioners:
whenever a clinical evaluation indicates that the client does not possess the capability or power and the outcome is very important, or when intervention is necessary to avoid high risk to others.
94
The principle of observing limits in DBT entails
Flexibly extending your limits when needed
95
The two categories of therapist therapy interfering behaviours are
Balance within the delivery of DBT and respect for the client
96
The most powerful reinforcer relied upon in DBT is the _________________. For this reason, contingency procedures can be harder to use until later in therapy.
relationship between therapist and client
97
Which of the following is accurate regarding placing a client on a therapy vacation?
A therapy vacation is the last resort before unilateral termination and only should be considered after the therapist has tried everything else

DBT Certification (3 decks)

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