DBT Skills Training Overview

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Questions and Answers

What is the primary difference between formal DBT skills training and individual DBT psychotherapy?

  • Individual therapy is less structured than skills training.
  • Skills training focuses solely on cognitive skills.
  • The content covered in each session.
  • The agenda is set before the client arrives in skills training. (correct)

Which component is NOT included in the structure of skills training sessions?

  • Review of homework practice.
  • Presentation of new material.
  • Group discussion of personal issues. (correct)
  • A closing wind-down session.

What assumption is made in DBT regarding group members?

  • They will follow the treatment without question.
  • They will independently set the session agenda.
  • They agree to abide by certain unprovable beliefs. (correct)
  • They can prove their beliefs through evidence.

What is the initial activity that begins each skills training session?

<p>Mindfulness exercise. (D)</p> Signup and view all the answers

What is the recommended duration for skills training sessions for individuals with severe disorders?

<p>2½ hours. (A)</p> Signup and view all the answers

Which of the following best describes the agenda setup in individual DBT psychotherapy?

<p>It is driven by the client's behavior since last session. (C)</p> Signup and view all the answers

What potential problem is mentioned for outpatient settings regarding homework review sessions?

<p>Clients might not have practiced their skills. (B)</p> Signup and view all the answers

What is the typical break duration incorporated during skills training sessions?

<p>15 minutes. (C)</p> Signup and view all the answers

What is the primary purpose of the session beginning ritual in group sessions?

<p>To practice mindfulness skills (C)</p> Signup and view all the answers

Why do some clients prefer the term 'homework practice'?

<p>They enjoy being treated like students (B)</p> Signup and view all the answers

What is a common practice implemented at the start of each mindfulness session?

<p>Ringing the mindfulness bell (C)</p> Signup and view all the answers

How does the session leader facilitate sharing among group members?

<p>Going around the circle systematically (B)</p> Signup and view all the answers

What is the purpose of ending the session with each person saying a personal goodbye?

<p>To provide a positive sendoff to departing participants (B)</p> Signup and view all the answers

What might be a concern regarding the terminology used in the group sessions?

<p>It might make members feel like children (A)</p> Signup and view all the answers

How long do most group sessions in the friends-and-family and skills training programs last?

<p>1 to 2 hours (A)</p> Signup and view all the answers

What is the maximum duration recommended for individual skills training sessions?

<p>45 minutes to 60 minutes (B)</p> Signup and view all the answers

What is typically expected from participants regarding snacks during group sessions?

<p>Each participant brings their own snacks (A)</p> Signup and view all the answers

Why are handouts printed on a different color of paper compared to worksheets?

<p>To help individuals with dyslexia read them more easily (A)</p> Signup and view all the answers

What does the session primarily focus on during group discussions?

<p>Between-session practice efforts (D)</p> Signup and view all the answers

Which of the following skills is NOT mentioned as part of the mindfulness practices in the sessions?

<p>Social skills (A)</p> Signup and view all the answers

What is the purpose of providing corrective feedback during the sharing of experiences?

<p>To promote individual skill development (C)</p> Signup and view all the answers

What should be addressed if there are issues related to attendance and participation in the group?

<p>They should be dealt with at the beginning of the session (B)</p> Signup and view all the answers

Which of the following is NOT a component of the standard skills training session format?

<p>Final assessment (D)</p> Signup and view all the answers

What is the primary objective of using labeled dividers in the training binders?

<p>To make it easier to find specific worksheets or handouts (B)</p> Signup and view all the answers

What is the primary purpose of weekly homework sharing in skills training?

<p>To motivate clients to practice skills. (D)</p> Signup and view all the answers

What is emphasized to clients during the first session of each skills training module?

<p>The rationale behind the module's skills. (B)</p> Signup and view all the answers

Which aspect of group dynamics is mentioned as potentially problematic during the sharing of homework?

<p>Clients' willingness to participate in discussions. (A)</p> Signup and view all the answers

Why is winding down time allocated at the end of a skills training session?

<p>To allow clients to process emotionally charged interactions. (B)</p> Signup and view all the answers

What is noted as a challenge in maintaining the homework sharing process?

<p>Frequent absences of clients. (D)</p> Signup and view all the answers

Leaders are tasked with convincing clients that skills training will result in what?

<p>Improvements in their overall lives. (D)</p> Signup and view all the answers

During the practice of skills, what is critical for the leaders to manage effectively?

<p>Time management during sharing sessions. (D)</p> Signup and view all the answers

Which of the following is NOT an expected challenge during homework sharing sessions?

<p>All clients successfully sharing experiences. (B)</p> Signup and view all the answers

What is the purpose of the last 15 minutes of each session?

<p>To allow participants to share observations (B)</p> Signup and view all the answers

How much time is generally allocated for reviewing new material in a session?

<p>50–60 minutes (C)</p> Signup and view all the answers

What aspect of the final session differs from the regular sessions?

<p>Review of all skills from the module (B)</p> Signup and view all the answers

Why is 1½ hours considered insufficient for a group session?

<p>There is not enough time for homework review (B)</p> Signup and view all the answers

What is one of the activities included in the individual skills training sessions?

<p>Practicing mindfulness skills (A)</p> Signup and view all the answers

What is typically done for participants leaving the skills training group?

<p>They are given a graduation certificate (B)</p> Signup and view all the answers

What is a key focus during the review of skills in the final session?

<p>Checking skill comprehension and generalization (A)</p> Signup and view all the answers

What approach is recommended for setting up the room for skills training sessions?

<p>Set up like a classroom setting (D)</p> Signup and view all the answers

What is a significant challenge when clients with dysregulated emotions seek therapy?

<p>Finding affordable therapists can be difficult. (D)</p> Signup and view all the answers

Why might some young children not access treatment on their own?

<p>Parents or guardians might refuse to take them. (A)</p> Signup and view all the answers

In what context should new behavioral skills be practiced?

<p>In all relevant situations where the skills are needed. (C)</p> Signup and view all the answers

What is a fundamental assumption about behaviors and their causes?

<p>Actions, thoughts, and emotions are causally linked. (A)</p> Signup and view all the answers

What is a more effective approach to changing unwanted behaviors than judgment and blame?

<p>Figuring out and changing the causes of behavior. (B)</p> Signup and view all the answers

What is a common limitation faced by public health clinics regarding psychotherapy?

<p>They often cannot provide individual psychotherapy. (D)</p> Signup and view all the answers

Who often helps clients find appropriate individual therapists when needed?

<p>Skills training leaders. (C)</p> Signup and view all the answers

What can result from prematurely terminating therapy for clients with dysregulated emotions?

<p>They may not find another therapist easily. (B)</p> Signup and view all the answers

Flashcards

Dialectical Behavior Therapy (DBT)

A type of therapy that focuses on teaching skills to manage emotions, distress tolerance, interpersonal effectiveness, and mindfulness.

Interconnectedness in DBT

A key DBT concept highlighting the importance of understanding the interconnectedness of all components within a system. Changes in one part can influence the whole.

Acceptance in DBT

Acknowledging and accepting the reality of a situation, even if it's painful or difficult. It's about recognizing the moment 'as it is' without judgment.

Distress Tolerance in DBT

The ability to tolerate distress without engaging in self-destructive or impulsive behaviors.

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Emotion Regulation in DBT

The ability to manage and regulate emotions effectively. It involves identifying, labeling, and understanding emotions.

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Interpersonal Effectiveness in DBT

Skills for navigating interpersonal relationships effectively, including setting boundaries, communicating assertively, and managing conflict.

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Mindfulness in DBT

The ability to pay attention to the present moment without judgment. It involves focusing on the senses and being aware of thoughts and feelings.

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Changing the Causes of Behavior in DBT

The process of changing behaviors by identifying and addressing the underlying causes, rather than just focusing on the symptoms.

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Skills Training Group Format

A structured session format for skills training groups, involving a regular pattern of skill review, new skill presentation, practice, and mindfulness.

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Session Wind-Down

A brief period at the end of each skills training session where group members share observations about the session, promoting mindfulness and reflection.

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Final Session Review

The final session of each module in a skills training group focusing on comprehensive review, skill generalization, and reflection.

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Individual Skills Training

Individualized sessions dedicated to teaching and practicing new skills, providing a more focused and personalized approach.

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Mindfulness Practice in Skills Training

The use of mindfulness practices, such as observation and description, to enhance awareness and self-regulation in skills training groups.

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Classroom Environment for Skills Training

A classroom-like environment that facilitates a sense of structure and learning within skills training sessions.

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Skill Generalization

The process of applying learned skills to different situations and contexts in daily life.

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Homework Review

The designated time within each skills training session dedicated to reviewing and practicing skills learned in previous sessions.

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Assumption in DBT

A belief that cannot be proven but is agreed upon by group members.

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Agenda in Individual DBT

The focus on behavior since the last session and the current session. The agenda is flexible, adapting to clients' needs.

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Agenda in DBT Skills Training

Focuses on teaching behavioral skills. The agenda is predetermined based on the skill being taught.

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DBT Skills Training Session Structure

A structured format for DBT skills training, typically divided into four sections: beginning ritual, homework review, new material, and closing wind-down.

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Beginning Ritual

The initial part of a DBT skills training session, often involving a mindfulness exercise.

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New Material Presentation

The presentation of new DBT skills and concepts during a training session.

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Closing Wind-Down

The concluding part of a DBT skills training session, often used for summarizing and reflecting on the session.

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Standard Skills Training Session Format

A structured approach to skills training sessions that involves a defined beginning, mid-session break, skill presentation, and a closing wind-down.

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Review of Homework Practice

A review of previously learned skills and practice exercises assigned in the previous session.

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Break

A short break during a skills training session to allow participants to rest and recharge.

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Presentation of New Material/Skills

The core part of a skills training session where new skills are presented and taught.

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Sharing Personal Experience

A practice where participants share their experiences with the group, providing valuable insights for the leader and other participants.

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Explaining Missed Sessions

A prompt given to participants who have missed previous sessions to explain their absence and catch up with the group.

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Sharing of Homework Practice Efforts

A practice that helps group members practice their skills, develop self-awareness, and share progress.

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Session-Beginning Ritual

A set of activities that begin each group session to promote a focused and mindful environment.

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Mindfulness Practice

Using various mindfulness techniques to cultivate attention, awareness, and acceptance.

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Mindfulness Bell

A bell used to signal the beginning and end of mindfulness exercises.

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Sharing Practice Efforts with the Group

Asking each group member to share their specific practice efforts from the previous week.

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Homework or Practice

The way group members describe their skills training practice, often using the term "homework."

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Semantics of Practice

The discussion about how group members choose to label their practice efforts, helping to avoid negative associations.

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Skills Training Content Discussion

The time in the group session where the main skills training content from Chapters 7-10 is discussed.

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Homework Practice in Skills Training

Ensuring clients practice skills between sessions is essential for their improvement. This includes analyzing non-practicing and motivating clients to attempt practice.

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Rationale for Skills Modules

The first 30 minutes of each new skills training module is dedicated to discussing the module's rationale, demonstrating its relevance to clients' lives, and building their confidence in learning the skills.

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Tailoring Skills to Client Needs

Leaders need to be creative in demonstrating how specific skills apply to particular problems, making the learning relevant and relatable for clients.

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Weekly Homework Sharing

The weekly sharing of homework practice efforts is a key component of DBT skills training.

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Encouraging Participation in Sharing

Every client, regardless of their willingness, is encouraged to share their experience with practicing skills.

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Importance of Wind-Down

Group skills training sessions can be emotionally charged and painful for some clients, requiring time for de-escalation and relaxation at the end.

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Time Management in Sharing

The primary leader needs excellent time management skills to ensure each client has sufficient time to share their homework practice experiences within the allotted session time.

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Modified Homework Review in Mindfulness

The time devoted to homework review may be adjusted during the first session of each iteration of Mindfulness module in an ongoing group due to its unique nature.

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Study Notes

Skills Training Sessions

  • DBT skills training sessions have specific attendance guidelines, requiring four individual sessions per week unless on a waiting list. Exceptions are for clients in other therapies.
  • Skills training effectiveness in reducing suicide attempts in suicidal individuals on waiting lists has been supported by Canadian research.
  • High levels of dysregulation or suicidality in clients necessitate extra support to master skills.
  • DBT skills training does not require individual therapists to be DBT-trained, but the importance of individual therapy is acknowledged.
  • Skills training leaders can sometimes act as short-term crisis therapists and assist clients in finding suitable individual therapists.

DBT Assumptions

  • People are doing the best they can, given their contextual factors.
  • People inherently want to improve their lives.
  • People have a need to change, try harder, and be more motivated to improve themselves. Although this isn't always the case, particularly in instances of consistent progress.
  • People are not solely responsible for all their problems, but they are responsible for finding solutions to address them. This does not exclude needing help in situations like childhood or disabilities.
  • Maintaining the use of learned skills across different contexts is essential.
  • All behavior, thoughts, and emotions are caused, and understanding those causes is necessary for change.
  • Judging and blaming are less effective than examining and finding solutions as to the causes of unwanted behavior.

Format of Ongoing Skills Training Sessions

  • The structure of skills training sessions differs from individual psychotherapy, as the therapy agenda is set before the session, rather than by the client's behavior.
  • Sessions typically include: beginning ritual, homework review, break, new material presentation, and wind down.
  • Session lengths vary depending on client needs. Individual sessions can last 45-60 mins, friends and family groups can be 90-120 mins.
  • Inpatient settings may split the sessions into two parts (homework review and new skills).
  • Shorter session times (1 hr 30 mins or less) are considered too short for certain difficult groups.

Session Room Setup and Materials

  • Skills training rooms should be set up to feel like a classroom setting.
  • Handouts are printed on different colours of paper to improve readability.
  • Three-ring binders with pockets help organized handouts and worksheets.
  • Specific forms for tracking practice exercises, DBT skill diaries and distress tolerance materials (e.g., cold packs, balls, balance boards) are used.
  • Snacks and drinks are provided at group sessions.

Session Beginning Rituals

  • A mindfulness practice leads the session.
  • Mindfulness exercises vary weekly to allow for different skill practice.
  • Members share their practice attempts from the previous week.
  • Clients who missed sessions explain their absence, and there is a short feedback period for the group.
  • A general warm-up or introductory discussion is included to address any group concerns/ issues.

Review of Homework

  • Members share their efforts to practice the skills between sessions.
  • Leaders use this phase to provide feedback or guidance on how skill practice can be implemented better.
  • The sharing segment is intended to ensure accountability and motivation for skill practice.

Break

  • Breaks are common (10-15 mins) halfway through the sessions to refresh and facilitate interaction among participants.
  • Group clients are encouraged to leave the break room.

Presentation of New Material

  • New skills are presented and discussed during the session after the break.
  • The rationale for the skills and how they are relevant to the participants' lives are discussed.

Closing Wind-Down

  • A wind-down period is crucial for clients with emotional dysregulation, assisting with managing emotional responses.
  • This segment is intended for de-escalation and to allow for reflection on observations of the day's events.
  • Techniques like "observe and describe" and "process observing" might be utilized.
  • Giving time for self-reflection and discussion before taking the group's adjournment helps to develop dialectical thinking.

Observing Limits

  • DBT emphasizes observing limits rather than explicitly setting them in skill training contexts.
  • Certain limits are implied through the boundaries of the sessions in skill training.

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