Research Paper on "Dialectical Behavior Therapy Dbt"

Research Paper 9 pages (2722 words) Sources: 6

[EXCERPT] . . . .

Dialectical Behavior Therapy

DBT

Dialectical Behavior Therapy is a medication meant to treat persons with mental health disorders especially borderline personality disorder. These patients normally have a history of urges to induce self-harm, self-mutilation, suicidal ideation among others. This therapy uses a cognitive-behavioral approach that deals with the psychological aspect of treatment (Heard, 2009). The theory depends on the approach that some people are more susceptible to a more tense reaction and unconsciously toward specific emotional situations, specifically those found in romantic, friends and family relationship. In the same theory, it has been found that some people react more than others in such situations or that their arousal level in those individuals normally rises faster than an average person's, they also gain a higher level of emotional stimulation and consumes a lot of time to return back to baseline arousal level.

Person's diagnosed with borderline personality disorder normally have the following characteristics, these include; they go through regular emotional swings, they sometimes see the world in black and white shades, more so they find themselves from one crisis after the other. Those who have this disorder normally fail to get the aid/assistance they deserve because they do not have the skills to cope with these irregular, sudden and intense surges of emotion (McMain, 2001).

Characteristics of Dialectical Behavior Therapy

The following are the characteristics of Dialectical Behavior Therapy, they include; it is cognitive based. The use of Dialectical Behavior Therapy helps to realize the thoughts, beliefs and assumption that the people have that makes life harder for him/her. Dialectical Behavior Therapy is also support-oriented, in that, it helps a person to identify their positive potential and build it up so that the person's with the disorder may have a positive attitude towards him/herself (Robins, 2001). The therapy is also collaborative in that it needs regular attention to relationships between the therapist and the patient. The therapy also, relies on total disclosure of problem, between the therapist and the person with the disorder, in a way that each one of them has to open up and share their problems in their efforts towards working them out (Clarkin, 2007). It is also collaborative in a way that the theory asks the people involved to complete homework assignment, they are also to try and practice by doing role play on the new ways they could interact with others people and to design ways a person can sooth him/herself when feeling disturbed or upset.

Distinctive theoretical features of a DBT

The first distinctive feature is that it is a principle driven treatment. This is because the treatment can be issued at any time and place and it uses a guiding theory to execute the required treatment plan. This guide helps the therapist to decide what strategy he/she is to employ on the patient in order to remove him/her from the current problem/situation. In DBT the therapist must constantly attend to the key principle provided in treatment. The therapist usually has some difficulties while using this principle because most of the principle-based treatments are related to one another (Heard, 2009).

The second feature is that DBT uses integrative treatment. This is because DBT treatment is through open ended dialog process where changes are accepted and used independently. The theory relies on the patient's description of situations to figure out the solutions to them; therefore, it combines all the information acquired to rectify a given problem (Willem, 2012).

Cognitive behavioral assessment procedures of DBT

This the first phases of a therapist-patient encounter. At this stage, the patient is normally asked several questions to give the therapist a better understanding of his/her condition so as to find the right treatment the patient need. The patient is normally asked to provide any information that makes him/her to think that he/she needs the treatment, he is also supposed to provide information concerning his/her problems, the therapist is also to find out about his/her general health, thereafter other information related to the history of substance abuse, trauma history and mental health issues are presented (Westen, 2000). Then the therapist will collect other clinical details based on the patient's assessment such as previous mental health status, hospital records, and any other treatment given previously

Therapeutic Interventions (Treatment)

Individual therapy involves weekly sessions where by problem behaviors such as purging, therapy interfering behaviors, self-mutilating and abuse of alcohol among other behaviors, are analyzed in great depth so that the causes and consequences which leads to, elicit or maintain the behavior is determined (McMain, 2001). Within this individual therapy, solutions are sought which will address what hinders skillful behavior by modifying reinforcement mechanisms, surpassing barriers through exposure to those factors, cognitive modification and direct tutoring skills. First, efforts are directed towards doing away with self-destructive tendencies/behaviors, then followed by life interfering behaviors are assessment and resolved (Clarkin, 2007). Through motivating the patient to use his/her own skillful behavior, the person may give the therapist his/her phone for consultations and assessment of skills outside their scheduled session.

Daily self-monitoring entails rating and doing follow ups on urges, emotions and behaviors relevant to the DBT case on a diary card. The patients work together with their therapist to design diaries which are relevant to their targeted areas for change. Here the patients are also supposed to do the skills homework which consists of practicing positive skills, observing and maintaining that experience (Willem, 2012).

Call coaching is also an essential tool because the patients can make calls to their therapist wherever they have an urge to engage in a maladaptive behavior and require help to overcome it. Patients are able to be given the necessary help for skill generalization in the environment they are in when going through intense urges and emotions (Heard, 2009).

Medication management is done by an individually assigned psychiatrist who is supposed to monitor and manage the medication he/she has given to the patient while still in the program.

Rehabilitation Counseling is used to help the patients to utilize their potentials sufficiently and to become independence in life.

Family therapy is conducted by individual's assigned therapist who will give both the family and multifamily groups their individualized sessions for support and education purposes. The family session is suitable because it helps the family to solve problems, make the home a better environment and more so to improve on communication (McMain, 2001).

Group skills training is where persons with BPD may lack the basic skills required to control their emotional experience, persevere painful experiences, engage in interpersonal relationships and manage cognitive dys-regulation. Group skills comprises of twice a week trainings sessions and it takes about 6 months to complete successfully, the duration may take this long because these patients normally have aversive emotions which often hinder the amount of learning that can take place (Willem, 2012).

Due to the difficultness in dealing with this disorder, there is needed to have a consultative approach towards treating it. This consultative team may comprise of a social worker, psychologist, psychiatrist, nurses among other resourceful people.

In DBT, group skills become necessary because it involves four modules. This includes interpersonal skills, mindfulness skills, emotional regulation skills and distress tolerance skills (Robins, 2001).

Mindfulness is the core skill taught in the group. Some of the advantages with enhancing this skill are that it is quite basic because most human beings possess it and it can be easily developed. It entails turning the patient's focus to a specified or a chosen direction and to observe, acknowledge and let go of other thoughts not in the path of the chosen focus. The aim of this skill is to fully participate and be aware of the present moment's events without any judgments. For instance a patient may be asked to imagine him/herself next to a waterfall's base, while seeing droplets of water fall down creating a rainbow illusion (Clarkin, 2007). The patient is not to change the illusion of what he/she is thinking about, but he/she should not interfere with them. Therefore, the skills enable the patient to know how to deal with arising issues and not being judgmental. Hence they can start being distant from emotions and learn to live a full life.

Interpersonal effectiveness involves strategies used to ask the patient what he/she needs, he/she saying no to various life threatening behaviors and to enable him/her to know how to deal with interpersonal conflicts. Interpersonal skill is also used in group skills because the patient may be able to explain his/her effective behavioral sequences well when another case of problematic situation is analyzed or discussed. Discussions of similar problematic situations may be used to analyze their own situation (Willem, 2012).

Distress tolerance is one of the most fundamental approaches to tackling mental health because it involves changing distressing circumstances and events. The patients are taught the skill to accommodate pain skillfully. This accommodation comes by when they are come to terms that they have a problem in a non-judgmental and non-evaluative fashion. Here, the persons with the disorder are… READ MORE

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