10/6/17. Disclosures. Learning Objec/ves. I have no financial or other conflicts to disclose

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1 DBT for the Treatment of Emo/on Dysregula/on: Theory, Techniques, and Updates Heather Brister, Ph.D. Clinical Psychologist Southern Arizona VA Healthcare System Disclosures I have no financial or other conflicts to disclose I do not benefit financially from the informahon I will be sharing nor do I have any conflicts of interest to disclose Learning Objec/ves ObjecHve #1: Describe the basic theory and techniques of DialecHcal Behavior Therapy (DBT) and its relevance for disorders of emohon regulahon. ObjecHve #2: List key updates between 1993 DBT skills manual and updated 2014 skills manual. ObjecHve #3: Describe how to use DBT Skills Training as stand-alone treatment to help pahents with emohon regulahon issues reach treatment goals. 1

2 Major Changes 1) Longer 329 pages (was 180 pages, including teaching notes) 2) More concrete Skills Ideas for Observing, Describing, ParHcipate, Wise Mind Expanded General Handouts How to chain, pros and cons, missing links analysis, assumphons of Skills Training 3) Middle Path Module DialecHcs ValidaHon, Problem Solving 4) When Crisis is AddicHon Skills Addresses behavioral addichons Major Changes Quizzes to check skill understanding PDF format; reproducible handouts and worksheets Sec/on Overview Each Module starts with Overview/Goal of Module Skills Pages 30, 88, 167, 266 These Handouts can be skipped AND provide good summary of Skills to be taught 2

3 Updated Manual and Teaching Notes Teaching Notes Now included handouts, worksheets, and very detailed teaching manual 2 books Variety of HW assignments; can vary or allow ophon of worksheets Page headings (cross reference worksheets and handouts) Cross Referencing 3

4 General Handouts Personalized Goals OpHons for Solving Any problem Solve Fell Beder Accept/Tolerate Stay Miserable Skills Training AssumpHons Biosocial Theory Chain Analysis Missing Links Analysis Mindfulness Now (57 pages; 27-84) Beder Defined Examples of skills Ways to PracHce What: Observing, Describing, ParHcipaHng Ways to PracHce How Skills: Non-Judgmentally, One-Mindfully, EffecHvely Ways to PracHce Wise Mind 4

5 Distress Tolerance Now (80 pages; ;) Guided Paired Muscle RelaxaHon Body Scan Includes Supplemental handouts When Crisis is AddiHon Harm ReducHon + 100% AbsHence DialecHcal AbsHnence, Clear Mind, Burring Bridges/Building New Ones, AlternaHve rebellion/adaphve denial Can be adapted for eahng Disorders, Substance Abuse, Computer AddicHon, Sexual AddicHon When Crisis is Addic/on:Path to Clear Mind Emo/on Regula/on Now ( 93 pages; pg ) ACT-like handouts on values and Goals AcHon Plans; 6 Step values to Goals (pg ) 5

6 Emo/on Regula/on 7 Step problem Solving Review of Opposite AcHon & Problem Solving Values and PrioriHes Cope Ahead Sleep Hygiene/Nightmare RescripHng Stand Alone protocols TroubleshooHng When Skills not Effectvice Check the Facts Interpersonal Effec/veness Now (68 pages; pages ) DEAR MAN; GIVE; FAST StarHng New RelaHonships/Ending DestrucHve RelaHonships Greater detail on ValidaHon 6 Levels Self and Others Middle Path Skills embedded in Mindfulness, Interpersonal EffecHveness, EmoHon regulahon DialecHcs Synthesizing Opposites EmoHon Mind + Reasonable Mind = Wise Mind Addict Mind + Clean Mind = Clear Mind ValidaHon Self and others Problem Solving Reinforcement PosiHve and NegaHve Reinforcement Behavior shaping Chain/SoluHon Analysis Understanding episodic problemahc behavior Missing Links analysis Task Analysis: How to Solve Problems 6

7 References Dimeff, L. A.; Koerner, K. (2007). DialecHcal Behaviro Therapy in Clincial PracHce; New York. Guilford press. Harley, R., Sprich, S., Safren, S., Jacobo, M., & Fava, M. (2008). AdaptaHon of dialechcal behavior therapy skills training group for treatment-resistant depression. Journal of Nervous and Mental Disorders, 196(2), Linehan, M. M. (2015). DBT Skills Training Manual (2 nd edi4on); New York. Guilford Press. Linehan, M. M. (2015). DBT Skills Training Handouts and Worksheets; New York. Guilford Press Linehan M. M. (1993). Skills Training Manual for Trea4ng Borderline Personality Disorder; New York. Guilford Press. Neacsiu, A. D., Bohus, M., & Linehan, M. M. (2014). DialecHcal behavior therapy: An intervenhon for emohon dysregulahon. Handbook of emohon regulahon, 2, Neacsiu, A.D., Eberle, J.W., Kramer, R., Wiesmann, T., Linehan, M.M. (2014) DialecHcal behavior therapy skills for transdiagnoishc emohon dysregulahon: A pilot randomized controlled trial. Behavioral Research and Therapy, 59, Safer, D. L; Telch, C. F.; Chen, E. Y. (2009). DialecHcal Behavior Therapy for Binge EaHng and Bulimia; New York; Guilford Press. 7