Silvereye Logo
 shopping cartuser account

Dialectical Behavior Therapy: A Contemporary Guide For Practitioners

$60.86  Paperback
Add to cartQuestions?

Lane D Pederson

  • Dialectical Behavior Therapy
  • Dialectical Behavior Therapy
    A definitive text for applying DBT, with evidence based yet flexible approaches to integrating DBT into practice.

264 pages
2015
ISBN: 9781118957912

A definitive new text for understanding and applying Dialectical Behavior Therapy (DBT).

  • Offers evidence-based yet flexible approaches to integrating DBT into practice
  • Goes beyond adherence to standard DBT and diagnosis-based treatment of individuals
  • Emphasises positivity and the importance of the client’s own voice in assessing change
  • Discusses methods of monitoring outcomes in practice and making them clinically relevant
  • Lane Pederson is a leader in the drive to integrate DBT with other therapeutic approaches

Table of Contents

Acknowledgments ix

To the Reader xi

Definitions xiii

1 Why Learn DBT? 1

2 Introduction to DBT: Brief Background and Current Controversies 4

3 The Contextual Model and DBT 9

  • Comparisons of DBT with Other Therapies 10
  • Therapeutic Factors that Most Affect Outcomes 13
  • Adopting versus Adapting Standard DBT: The Question of Treatment Fidelity 15
  • The Answer to Fidelity: EBP 21

4 DBT: An Eclectic yet Distinctive Approach 23

5 Is It DBT? A Guide for DBT-Identified Therapists and Programs 27

6 Dialectical Philosophy 31

  • Dialectics in Practice 32
  • Validation versus Change 32
  • Acceptance of Experience versus Distraction from or Changing Experience 33
  • Doing One’s Best versus Needing to Do Better 34
  • Noting the Adaptive in What Seems Maladaptive 34
  • Nurturance versus Accountability 35
  • Freedom versus Structure 36
  • Active Client versus Active Therapist 37
  • Consultation to the Client versus Doing for the Client 37
  • Dialectics and Evidence-Based Practice 38
  • When Not to Be Dialectic: Dialectical Abstinence 38
  • Dialectics with Clients 39

7 The Biosocial Theory: Emotional Vulnerability, Invalidating Environments, and Skills Deficits 41

  • The Role of Invalidation 44
  • How the Biosocial Theory Guides Practice 45
  • Being Flexible to the Client’s Theory of Change 47

8 Client, Therapist, and Treatment Assumptions 49

  • Client Assumptions 49
  • Therapist Assumptions 51
  • Treatment Assumptions 53

9 The Five Functions of Comprehensive DBT 55

  • Motivate Clients 55
  • Teach Skills 56
  • Generalize the Skills with Specificity 56
  • Motivate Therapists and Maximize Effective Therapist Responses 57
  • Structure the Environment 57

10 Treatment Structure 58

  • How Much Structure? Level-of-Care Considerations 59
  • Program Treatment Models 61
  • Individual Therapy Treatment Structure 70
  • Group Skills-Training Session Structure 72
  • Additional Treatments and Services 73
  • Expectations, Rules, and Agreements 73

11 DBT Treatment Stages and Hierarchies 79

  • Pretreatment Preparation 80
  • Pretreatment and the “Butterfly” Client 81
  • Stage One: Stability and Behavioral Control 82
  • Stage Two: Treating PTSD, Significant Stress Reactions, and Experiencing Emotions More Fully 85
  • Stage Three: Solving Routine Problems of Living 85
  • Stage Four: Finding Freedom, Joy, and Spirituality 85

12 The DBT Therapeutic Factors Hierarchy 87

  • 1. Develop and Maintain the Therapy Alliance 87
  • 2. Develop Mutual Goals and Collaboration on Methods 88
  • 3. Identify and Engage Client Strengths and Resources to Maximize Helpful Extratherapeutic Factors 89
  • 4. Establish and Maintain the Treatment Structure 89

13 Self-Monitoring with the Diary Card 90

14 Validation: The Cornerstone of the Alliance 96

  • Levels of Validation 97
  • Validation versus Normalization 99

15 Commitment Strategies 101

16 Educating, Socializing, and Orienting 107

17 Communication Styles 110

  • Reciprocal Communication 110
  • Irreverent Communication 114

18 Mindfulness 118

19 Skills Training 125

20 Changing Behaviors 133

  • Behavioral Contingencies 139
  • Behaviorism and the Therapist 142
  • The Most Effective Methods of Changing Behaviors 143

21 Behavioral Analysis 150

  • Behavioral Analysis Example 152

22 Dialectical Strategies 160

23 Cognitive Interventions 168

24 Telephone Coaching 177

25 Dealing with Safety Issues 180

  • Essential Practices 180
  • Suicide Risk Factors 183
  • Protective Factors 183
  • Suicide Assessment 184
  • Self-Injury Assessment 187
  • Creating the Safety Plan 190
  • Safety or No-Harm Contracts 193
  • From a Safety Plan to a Safety Commitment 194

26 Use of the Hospital 197

27 Consultation 200

28 Evaluation of Clinical Outcomes 209

Appendices

  • Appendix A Mindfulness Exercises 216
  • Appendix B Plans for Safety and Skills Implementation 218
  • Appendix C Professional Growth in DBT 227

References 229