HC.11

Question 1

Describe what dialectical behaviour therapy is

Answer 1

DBT combines standard CBT techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness

Question 2

Name 6 assumptions of DBT

Answer 2

1. Patients with PDs are doing the best they can and they need to do better, try harder, and be more motivated to change
2. patients may not have caused all of their problems, but they have to solve them anyway
3. the lives of those with a PD in DBT are unbearable as they are currently being lived
4. patients must learn new behaviors in all relevant contexts
5. patients cannot fail therapy
6. therapists need support

Question 2

Name 5 functions of DBT

Answer 2

1. improve client motivation to change
2. enhance client capabilities
3. facilitate generalization of client capabilities to their natural environments
4. enhance therapist motivation and capabilities to treat clients
5. help structure the environment to bolster client and therapist capabilities

Question 3

Name 5 treatment components of DBT

Answer 3

1. Individual therapy: focus on building a strong therapeutic relationship and using a balance of acceptance and change strategies
2. Group skills training: helps client to replace problematic behaviors with healthier ones
3. phone coaching: provides additional support to clients outside scheduled sessions
4. therapist consultation team: ensures therapist effectiveness and adherence to the DBT model through regular meetings and support
5. Ancillary interventions: exposure therpay or additional sessions based on individuals needs

Question 4

Describe the 4 stages of therapy:

Answer 4

1. pre-treatment commitment
2. Improve behavioral control and increase skill use:
   - 6 months
   - weekly skills classes
   - focus on SIB (self-injurious behaviors), TIBs (therapy-interfering behaviors), and QIBs (quality-of-life interfering behaviors)
3. Improve emotional regulation and experiencing:
   - address PTSD symptoms and improve emotion regulation
   - exposure therapy
   - reducing avoidance behaviors
4. Bolstering overall quality of life and improving capacity for joy
   - reduce symptoms of depression and anxiety
   - develop more effective behaviors
   - CBT
   - acceptance
   - mindfulness

Question 5

Name 5 treatment targets (hierarchically)

Answer 5

1. Self-harm and life-threathening behaviors
2. Therapy-interfering behaviors (TIBs)
3. Quality-of-life interfering behaviors (QIBs)
4. Skill acquisition: mindfulness, emotion regulation, distress-tolerance techniques, interpersonal effectiveness
5. Dialectics and dialectical dilemmas:
   - emotional vulnerability (intens emotional pain) and self-invalidation (self-loathing)
   - active passivity (exhibit demanding and hopeless behaviors) and apparent competence (may appear capable but struggle internally):
   - unrelenting crisis (lack of support, devastating life events, inhibited grieving)