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Using DBT in COD Populations

TAMARAH L. GEHLEN LMFT LADC CCTP

The “D” in DBT…

dialectics the art of investigating or discussing the truth of opinions. u  synonyms:

discussion, debate, dialogue, reasoning, argumentation

DBT … it’s not just for

Borderlines anymore!

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There are a number of similarities in persons dealing with co-morbid

disorders and those who are diagnosed as personality-disordered

There are a number of important aspects about DBT that bring

results – one of the most important is the stance of the therapist…

ACCEPTANCE – NONJUDGMENTAL - VALIDATING

Helping clients create mental balance…

u  The first step is to help clients see where they spend more mental time, and how to make decisions

u  Based not just on rational or emotional processing alone, but from a wise mind that takes in to account both the rational and emotional urges

EMOTIONAL MIND

WISE MIND

RATIONAL MIND

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…mindfulness

u Focus on senses

u Daily quiet time

u 10 details

u One task at a time

u Holding feelings

u Balloon release

Opposite to

Emotion

Helping clients to use skills to act in opposite to what they are feeling

Urge Surfing Riding the

wave of feeling or the urge to allow it to rise an fall away …

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Feeling overwhelmed? IMPROVE it!

u  I - IMAGERY

u M -MEANING

u P - PRAYER

u R - RELAXATION

u O – ONE THING AT A TIME

u V - VACATION

u E - ENCOURAGEMENT

EVERYDAY ACCEPTANCE

MEETING SMALL EVERYDAY REALITIES WITH ACCEPTANCE RATHER THAN BEING FRUSTRATED WHEN THINGS DON’T GO

OUR WAY…

Using SOLVED …

u  S – STEP BACK & BE OBJECTIVE u O- OBSERVE AVAILABLE OPTIONS

u  L- LIMIT BARRIERS u V – VALUES DRIVEN

u E – EFFECTIVENESS FIRST u D – DIALECTICAL THOUGHT &

ACTION

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B – be aware of self O – observe others & situation U – understand limits N – negotiate sometimes D – differences exist A – always R - remember your values Y – your safety comes first

Creating change in thought & behavior

u Establishing goals – “target behaviors”

u Eliminating “treatment interfering behaviors”

u Diary Cards are filled out to see what skills are working, what needs work, and to check on progress of target behavior

Helping clients to see REASON…

u R – RATIONAL u E – EMOTIONS MATTER u A- ALTERNATIVE VIEWS u S – SELF-TRUST u O – OLD BELIEFS

u N – NEW THOUGHTS & BELIEFS

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Distracting with ACCEPTS …

u A – ACTIVITIES

u C – CONTRIBUTING

u C- COMPARISONS

u E – EMOTIONS

u P – PUSH AWAY (NEGATIVE)

u T – THOUGHTS &

u S - SENSATIONS

Clients LOVE to have helpful tools & skills that

they can immediately use –

becoming fully trained in DBT will give you a

variety of tools & resources to further

empower your clients with

ENJOY TODAY’S PRESENTATION?

WANT TO SEE MORE?

Call Tamarah at 320-583-0145

www.tamarahgehlen.com