Outline

Foundations of DBT

• The Story of DBT
• Explicit focus on validation
• Cognitive-behavioral change strategies
• Skills training
• Consultative approach
• Mindfulness
• Dialectical balance
• Five functions of DBT
• Is it DBT?: What’s needed in a DBT clinical process

Dialectical Philosophy. What IS it, and HOW is it Used?

• Dialectics explained
• Dialectical assumptions
• Dialectics in action
• Dialectical Abstinence. When NOT to be dialectical

Core Assumptions of DBT: Shaping the Therapy

• Acceptance and nonjudgmental stance
• View of clients, therapist and therapy

DBT Models: Standard and Beyond

• DBT Modes and Formats
• DBT Research: Understanding and Context
• Evidence-Based Practice versus
• Evidence-Based Treatments
• Understanding how therapy works
• Six decades of empirical research
• Maximizing therapeutic factors, DBT-style

Biosocial Theory: Guiding the Therapy

• Biosocial theory of difficulties
• How theory drives therapy
• Update to Theory: RO DBT

Getting Started: Therapy Structure

• Structure as a therapeutic factor
• Structuring the environment
• DBT Stages
• Identifying treatment targets: suicidality, self-injurious behavior (SIB), therapy-interfering behavior (TIB), and other targets

Special Populations and Settings

• Children and Adolescents
• Substance Use Disorders
• Levels of Care

Mindfulness and DBT

• Mindfulness explained
• Mindfulness of the approach
• Mindfulness as a therapy technique
• Mindfulness in life

DBT Skills Training

• Integrating skills into therapy
• Using skills to develop new behaviors
• Methods for skills training

Mindfulness: The Path to Wise Mind

• What skills: observe describe, participate
• How skills: nonjudgmental, one-mindful, effectively
• Mindfulness practice and application

Teaching Dialectics

• Identify dialectical dilemmas
• Activate Wise Mind action
• For adolescents and parents: Middle path
• For substance use disorders: dialectical abstinence

Distress Tolerance

• Wise mind ACCEPTS
• IMPROVE the moment
• Pros and cons
• Radical acceptance/turning the mind

Emotion Regulation

• Model of emotions
• PLEASED
• Build positive experiences
• Opposite action

Interpersonal Effectiveness

• FAST skills
• GIVE skills
• DEAR MAN skills

Supplemental and Updated Skills and Modules

• Urge surfing
• Bridge burning
• TIP
• DBT Clinical Process

Diary Cards

• Standard
• Adapted for special populations

Behavioral Analysis (Chain Analysis)

• Getting the client on board
• Build awareness and options
• Bridging into solution analysis

Starting Out: Commitment Strategies Validation

• A multi-layered approach
• As an exposure technique
• Used dialectically with change
• Difference from normalization

Change Interventions

• Behavioral principals
• Contingency procedures
• Best behavior change methods
• DBT-style cognitive interventions

Exposure Techniques

• When to use (and not to use)
• Exposure protocols
• Alternatives to exposure

Communication Styles

• Reciprocal
• Irreverent

Consultative Group and Treatment Teams

• Increase your motivation
• Develop effective responses
• Qualities of effective treatment teams

Assess and Manage Self-Injurious Behavior (SIB)

• When is SIB life-threatening?
• Creating alternatives

Assess and Manage Suicidal Ideation (SI)

• Suicide assessment techniques
• Establishing safety protocols
• Safety plans and safety commitments

Hospitalization Issues

• Effective use of the hospital
• Transitions in and out

Next Steps

• What you learned and what you need
• Developing your plan
• Taking action