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1、DBT and Recovery,Michelle Rollins, MA, LPC, CACIII Jennifer Leeson, MSW, LCSW,Objectives,Explain basic tenets of DBT Discuss fundamental components of recovery Discuss 4-step process of hope Discuss what helps and hinders in the recovery process,Dialectical Behavior Therapy,What is DBT?,Developed at
2、 the University of Washington by Marsha Linehan, Ph.D. Empirically-supported “modified” cognitive behavioral treatment for borderline personality disorder Particular efficacy in consumers with chronic suicidal or self-harming behaviors Provides tools and strategies to improve quality of life, facili
3、tate change, manage crises, and eliminate dysfunctional behaviors,Research on DBT,Originally validated in two RCTs comparing DBT to TAU in BPD and BPD + SA DBT patients vs TAU patients Less likely to drop out of treatment Fewer/less medically severe self-harm behaviors Fewer/shorter inpatient hospit
4、alizations Greater scores of global and social adjustment,Research on DBT,Other empirical studies comparing DBT to TAU Decreased suicidal ideation Decreased depression, hopelessness, anger Greater treatment retention,Biosocial theory of BPD,Emotion dysregulation Biological disposition + environmenta
5、l context Emotional vulnerability High sensitivity/intense response to stimuli Slow return to baseline after emotional arousal,Modes of delivery in DBT,Outpatient individual psychotherapy Outpatient group skills training Telephone consultation Case consultation for therapists Ancillary treatment,Ski
6、lls modules in DBT,Core Mindfulness Goal: to develop a lifestyle of participating with awareness Identity disturbance; feelings of emptiness Interpersonal Effectiveness Goal: to apply specific skills in interpersonal encounters to obtain objectives by asking or saying no, maintain the relationship,
7、maintain self-respect, analyze the situation and determine goals Unstable relationships; efforts to avoid loss,Skills modules in DBT,Emotion Regulation Goal: to apply specific skills to identify, label, and regulate emotions within a context of self-validation and non-judgment Affective instability;
8、 problems with anger Distress Tolerance Goal: to apply specific skills to tolerate and survive crises and to accept oneself and the current situation in a nonjudgmental fashion Impulsivity; self-harm behaviors,Recovery,What is recovery?,MHCD definition of recovery: An ongoing process of self-directe
9、d healing and transformation (adopted from Pricilla Ridgeway),Fundamental components,Self-direction Determining own path of recovery Individualized/person-centered Multiple paths to recovery based on individual strengths Empowerment Authority to participate in decisions,Fundamental components,Streng
10、th based Valuing/building on talents, coping abilities, etc. Peer support Encouragement, sense of belonging Respect Eliminating stigma, self-acceptance,Fundamental components,Responsibility Personal responsibility to promote self wellness Holistic Mind, body, spirit, community Non-linear Growth, set
11、backs, learning from experience,Fundamental components,Hope Catalyst of the recovery process,Four step process to hope,Empathize with reality of despair Establish legitimacy of need to ask for extensive help Identify meaningful, attainable measures of successful progress Emphasize a hopeful vision o
12、f pride and dignity,What helps in recovery?,Belief that recovery is possible Positive expectations Caring attitude Being treated with respect Well trained staff Fostering self-empowerment,What hinders recovery?,Staff who are burned out Mistrust, paternalism, superiority Coercion Not understanding co
13、nsumers experiences,Wrap-up,Questions and Feedback,Contact information-DBT,Michelle Rollins michelle.rollinsmhcd.org 303-504-1054 Jennifer Leeson jennifer.leesonmhcd.org 303-504-1067,Contact information-recovery,Roy Starks (specific recovery information, measurement/outcomes) roy.starksmhcd.org 303-504-1721 Jay Flynn (general recovery questions, training) jay.flynnmhcd.org 303-504-1035,DBT Resources,Behavioral Tech Website: http:/behavioraltech.org/ Dimeff, L.A. Rathus, J.H., & Linehan, M.M. (2006). Dialectical Behavior Therapy with Suicidal Adolescents. New York: Guilford Press.,
