standard (original) dialectical behavior therapy

DBT PROGRAMS HAVE 5 COMPONENTS, 3 OF WHICH ARE PATIENT INCLUSIVE:

I

Individual Therapy: The therapist and patient discuss issues that come up during the week (recorded on diary cards) and follow a treatment target hierarchy.

Targets, in order of treatment urgency are:

1. Self-injurious and suicidal behaviors, or life threatening behaviors.Therapy Interfering Behaviors.

2. Using hospitalization as a means to cope.

3. Quality of life issues and threatening behaviors or circumstances.

4. Skills Aquisition and Application are a co-occurring target and addressed in skills classes.

II

Skills Class: Classes ordinarily meet once weekly for 1 ½ - 2 hours/week. Here one learns to use specific skills that are broken down into 6 skill sets:

1. core mindfulness: skills on learning to be in the present and live life effictively.

2. interpersonal effectiveness: skills to learn how to get needs met, build relationships, & increase self-respect

3. emotion regulation: skills on how to choose emotions, their intensity, and control level of emotional expression.

4. distress tolerance: skills to be able to tolerate unwanted moments without making things worse or hurting yourself more

5. walking the middle path: a unit on behaviorism, dialectics, validation theory, and biosocial theory.

6. radically openness: skills on receptivity to new ideas, new behaviors, and flexibility in approaching situations.

A skills training class combines lecture, discussion and practice exercises to develop and refine skills in non-judgmental, present moment awareness and acceptance, distress tolerance, emotion regulation, interpersonal effectiveness, and problem-solving. The format is as follows:

Classes        1-9: mindfulness + interpersonal effectivenss + walking the middle path

Classes    10-18: mindfulness + emotion regulation

Classes    19-27: mindfulness + distress tolerance

Enrollment is rolling.

III

Skills Coaching: A primary goal of coaching is to ask for help before you engage in the behaviors so you can be skillful in resolving issues. A secondary goal is to use coaching for clarification on homework.

IV

Tream Consultation: a requirement of a true DBT practice. Your therapists evaluate treatment efficacy and application. This is done weekly to ensure stable, ongoing progress and dialectical balance in the therapeutic relationship.

V

Ancillary Treatment: referrals to psychiatry, biofeedback, equine therapy, occupational therapy, nutritional support, diagnostics--made as necessary or as requested.