DBT Skills Training and Treatment Procedures

Observing and describing a client's behavior without judgment, especially when it is challenging.

Accepting a client's behavior without trying to change it immediately.

Doing the opposite of what you feel like doing to manage strong emotions.

Behaviors that disrupt the therapy session but don't completely derail it.

Using humor or irreverence to respond to a client's behavior, especially when you are tempted to react negatively.

Not addressing therapy-interfering behaviors systematically in skills training.

Skills training focuses on helping clients improve their skills rather than addressing their life challenges or crises.

The skills training approach focuses on teaching clients how to use their new skills in real-life situations.

The tendency for group leaders to experience heightened anxiety and attempt to control disruptive members, often leading to judgmental behavior towards the participant.

A therapeutic approach where the group leader focuses on facilitating skill acquisition and practice, rather than directly addressing disruptive behavior.

The act of ignoring or minimizing disruptive behavior, allowing the client to experience the natural consequences of their actions.

Maintaining a calm and neutral demeanor despite challenging situations, reducing emotional reactivity and judgment.

A therapeutic technique involving treating individuals as if they are cooperating, even when they are not, promoting a sense of partnership and encouraging desired behavior.

The process of practicing and applying learned skills to real-life situations.

The act of repeatedly practicing and reinforcing learned skills to improve proficiency and retention.

Behaviors that pose a serious threat to the continuation of therapy, such as violent outbursts or disruptions during group sessions.

The risk of the therapist falling into their own emotional reactivity instead of remaining objective and supportive.

A structured protocol designed to address disruptive behaviors hindering therapy progress.

Actions aimed at stopping disruptive behaviors that jeopardize therapy sessions.

Actions taken when a client demonstrates a high risk of self-harm.

Individual therapy sessions that occur before or after a skills training session to address specific issues or challenges.

Teaching skills in interpersonal effectiveness, emotion regulation, distress tolerance, and mindfulness.

Strategies used to control destructive behaviors quickly, including positive and aversive reinforcement.

The therapist's responsibility to work with clients on destructive behaviors that are not directly addressed during skills training.

A technique where the therapist focuses on teaching new skills to the client.

A type of skill training where the therapist teaches the client to tolerate distressing situations or emotions without engaging in self-destructive behaviors.

A type of skill training that focuses on developing the ability to be present in the current moment and accept situations as they are, rather than resisting them.

A DBT skill training procedure that involves the therapist modeling the desired behavior for the client to observe and learn from.

A DBT skill training procedure that involves providing specific instructions or information about how to perform a skill.

A designated time at the end of a skills training session to address any therapy-interfering behaviors observed during the session. It also serves as an opportunity to reflect on the progress of the therapy process.

Strategies used to manage therapy-interfering behaviors during skills training sessions. These can include ignoring brief behaviors, asking the client to stop a behavior directly, or using the behavior as a teaching opportunity for the relevant skill.

A type of therapy-interfering behavior characterized by emotional reactivity, often leading to an inability to engage in learning and practice. Example: A client being so upset about an argument they had that day, that they can't focus on the skill training.

A type of therapy-interfering behavior characterized by the client's resistance to actively engage in skills training. Example: A client refusing to participate in role-playing exercises.

A type of therapy-interfering behavior characterized by the client's inability to tolerate criticism. Example: A client getting defensive and angry when a therapist suggests a different way of approaching a situation.

A type of therapy-interfering behavior characterized by restlessness and inability to stay focused on the task at hand. Example: A client fidgeting constantly, shifting their position frequently, or pacing around the room.

A type of therapy-interfering behavior characterized by the client engaging in activities that are not related to skills training. Example: A client doodling on a notepad, checking their phone or playing with a fidget toy.

Strategies refer to coordinated activities, tactics, and procedures used by skills trainers to achieve treatment goals, particularly the acquisition and use of behavioral skills.

Skill training in DBT is one of four sets of change procedures, alongside contingency management, individual psychotherapy, and phone coaching.

In DBT, skills training focuses on acquiring and using behavioral skills to address various issues, including reducing self-harming behaviors, minimizing therapy-interfering behaviors, and improving quality of life.

Behaviors that threaten to derail therapy completely (like self-harm or suicide threats) are addressed first in skills training.

Behaviors that slow down the progress in therapy, but don't pose a major threat, are addressed after the critical ones.

In contrast to individual psychotherapy, therapy-interfering behaviors are dealt with after immediate safety concerns in DBT skills training.

In DBT skills training, acquiring and strengthening skills is essential. However, this agenda is temporarily set aside if someone exhibits behavior that could jeopardize therapy, such as self-harm or suicidal threats.

The order of addressing behaviors is determined by their potential to disrupt therapy, prioritizing safety and then transitioning to skill acquisition and generalization.

Therapy interfering behaviors are those that prevent individuals from making progress and benefiting from therapy. They are addressed after safety concerns in DBT skills training.

Self-injurious acts and suicide crisis behaviors are considered the most critical to address in DBT skills training, as they pose immediate threats to safety and well-being.