Application Worksheet # 6 Dialectical Behaviour Therapy

Young person in scenario:

Group Members Contributing:

Fundamental Principles:
3 pillars of DBT:
Dialectics; recognition of competing opposites in all aspects of life, beliefs, behaviours, etc.
Behaviour Science: analysis and change of stimulus-response patterns
Zen Buddhism: mindfulness, acceptance

DBT views struggles as a consequence of underlying emotional dysregulation

Emotional dysregulation is influenced by 2 significant factors:
1. Lack of important interpersonal, self-regulation and distress tolerance capabilities (self-
soothing)
2. Personal and environmental factors that impede the development of new skills and self-
soothing capacities
Goal/Intention of Therapy

1. Increasing the youths’ and families’ coping capacities by teaching skills in self-regulation
(emotional regulation and mindfulness), interpersonal effectiveness, distress tolerance,
and balanced thinking
2. Structuring the environment to motivate, reinforce and individualize appropriate use of
skills
3. Increase teens’ motivation to use new skills, reduce the use of previous dysfunctional
behaviours
4. Encourage the generalization of new skills into life situations

Regulation:

Emotional Regulation- reactivity, outbursts, negative emotional states (depression, anger, shame,
guilt, anxiety) deficits in positive emotion and difficultly modulating emotions

Self dysregulation- Lacking awareness of emotions, and thoughts

Interpersonal dysregulation- unable to form/maintain interpersonal relationships, abandonment
and difficulties getting needs and wants met in relationships

4 DBT Skills Modules:

Mindfulness

Distress Tolerance

Interpersonal Effectiveness

Emotional Regulation

* Walking the middle path; self-management (added module specifically for adolescents)

Additional Concepts:

“Wise Mind” – rational and emotional minds working in balance

Radical Acceptance – acceptance of things that cannot change, and seeking the beneficial aspects

DEAR MAN Skills enhance a person’s ability to express and negotiate their needs within
interpersonal relationships:

Describe- the situation

Express- feelings and opinions
Assert- by asking for what you want
Reward- ahead of time by expressing appreciation
Mindful-stay focused on your goals, don't get distracted
Appear Confident- tone of voice, eye contact, head high
Negotiate- offer to give to get- how can you help the other person?

GIVE Skills describe the counsellor’s presentation:

Gentle- be nice and respectful- don’t use threats

Interested- be interested in what another is saying
Validate- respect someone’s position and reality
Easy manner- avoid being stiff, serious or overly firm
Please answer the following 3 questions. For the first 2, answer from the perspective of this
week’s philosophy.

#1. How would someone working from this perspective view the young person in your scenario?
What have been the key events or factors that have affected them and contributed to their
struggles? How do these factors affect them? Are there positive or resilience factors evident?

#2. What would someone working from this perspective do to try to help the young person?
What needs to change for things to improve? What interventions, techniques, or experiences
might they try to facilitate?

Please answer the following question from your own (group) perspective:
#3. How does this approach fit with a Relational CYC perspective? Do the concepts and
approaches fit well within a CYC approach, or not? What specific aspects or ideas fit, or don’t?
If some ideas do not fit well, how could this be resolved? Are there any adaptations to this
approach that you would suggest to make it more complementary to a Relational CYC approach?