DialecticalBehaviourTherapy：辩证行为疗法.ppt

Dialectical Behaviour Therapy in Perth North Metro Area Margaret Cole 11th July 2006 Goal To Build A Life Worth Living Steps 1. Clear Structure 2. Do Behaviour Therapy 3. Add Validation 4. Add Dialectics 5. Add Mindfulness 1. Clear Structure Assumptions About Clients what the therapist does afterwards is a better index of good therapy” Linehan Dialectical Therapist Techniques Finding a balance between apparently opposing stances Validation VS Problem Solving Active observing Reflection Search for validity Active approach Behavioural focus Dialectical Behaviour Patterns: Balanced Lifestyle Walking the middle path through the following areas Skill enhancement VSSelf-acceptance Problem solvingVS Problem acceptance Affect regulationVS Affect tolerance Self-efficacyVS Help seeking IndependenceVS Dependence TransparencyVS Privacy 5. Add Mindfulness General Goal of Skills Training To learn and refine skills in changing behavioural, emotional and thinking patterns associated with problems in living, that is, those causing misery and distress. General Points nShot gun approach some of the skills will work for some of the people some of the time nThe parts of the skills are rarely new, but the combination often is nClients need to be convinced that what theyre learning is going to be useful, relevant to them (marketing the skills) nClients will often have attended other groups, need to discuss how this might be different (e.g. not process oriented) nEmphasize goal of long-term relief vs. immediate relief nEmphasize need for practice, practice, practice The Skills nCore mindfulness nInterpersonal effectiveness nEmotion regulation nDistress tolerance Mindfulness “bringing an unshakeable friendliness and deep degree of curiosity and interest to what is happening in and around you and doing this again and again and acclimatising to this way of being” Tarchin Hearn “Mindfulness in totality has to do with the quality of awareness that a person brings to activities” Marsha Linehan Interpersonal Effectiveness Asking & Saying No Objectives Effectiveness How to get what you want Relationship Effectiveness How to maintain the relationship Self-Respect Effectiveness How to keep your self-respect Emotion Regulation Goals 1. Understand emotional experience 2. Reduce emotional vulnerability 3. Decrease emotional suffering Distress Tolerance Surviving a situation you cant change Crisis Survival Reality Acceptance North Metro DBT Program nReferral Process nEntry to group every 6 months n12 month commitment n8-10 per group desirable nWeekly skills group, 2 hours