Monday, 5 February 2018

Dialectal Behavior Therapy | What is it?

Hello and welcome back to my blog. I keep finding myself getting quite stuck on what to post for my Mental Health Monday posts as I am not sure if you prefer more informative posts and advice, or posts where I just chat about my opinions on topics.. please let me know as I really can't tell but for now, I am doing a bit of both. Due to the fact that I did a small amount of Dialectal Behavior Therapy (DBT), I thought that I would try and explain each of the skills to the best of my ability as I am aware that DBT isn't available to everyone. I am just going to say.. I am not qualified in DBT, I am just trying to share the skills in order to help others.

What Is DBT?

DBT is a talking therapy which is based on Cognitive Behavioural Therapy (CBT), but has been adapted to help people who experience emotions very intensely. Like CBT, DBT aims to help you change unhelpful behaviours but by additionally also focusing on accepting who you are. Within DBT, the relationship between you and your therapist is very important and once trust is built, is used to prompt and motivate you to want to change. According to MIND, "the goal of DBT is to help you learn to manage your difficult emotions by letting yourself experience, recognise and accept them. Then as you learn to accept and regulate your emotions, you also become more able to change your harmful behaviour. To help you achieve this, DBT therapists use a balance of acceptance and change techniques."

Within DBT, Diary cards are used to help track your emotions, destructive behaviours, urges, medications and which skills you have been using. They have to be filled out every day and completely honestly. Usually, you would meet with your therapist once per week. Diary cards will also contain sections for homework that your therapist would have set you for the upcoming week. I will say now, DBT is difficult, it can be very draining and is a lot of hard work but it can be beneficial for many people in the long run but if you want it to work, you have to be willing to change your behaviours. Upon starting DBT, I found it difficult to remember to fill in my Diary cards, meaning that I had to fill them in all at once, so they weren't always accurate. Despite not being in DBT, I still use the Diary cards as I find them helpful to track how things are going. For every service, the Diary cards will look quite different, but I will attach one that I found online here, that you can print off and give a go.


Another part of DBT is the chain analysis which are essentially a step to step document of an incident that had happened right from the morning before it happened to the night after. Chain analysis will commonly be used if you have self harmed, attempted suicide, drank alcohol, not eaten or done drugs depending on what behaviours you are struggling with. They are very difficult and intense and you have to talk through absolutely everything that happened before, after and during the incident. I honestly can't even count the amount of times that a chain analysis has left me in tears but again, they're beneficial and they make you not want to have to fill them in again. An example of what to include in a chain analysis can be found here but if you want me to, then I can do a whole blog post on them.

Skills

Within DBT, there are a whole range of skills that can be split into four different categories. Some skills may be explained slightly differently across different services but they all mean the same thing. During DBT, these skills will mostly be taught within a group setting that occurs once a week. I found the groups the most difficult as I cannot stand being sat in a room full of people I don't know, but they are very informative and quite helpful to some. Within the group, you'll be given homework alongside your individual homework from your therapist, that usually relates to the skills learnt. The DBT Skill modules are categories into;

  • Mindfulness Skills
  • Emotion Regulation Skills
  • Interpersonal Effective Skills
  • Distress Tolerance Skills
Mindfulness Skills are a range of skills that can be used to help focus your attention to the present time instead of being distracted by worries about the past or future. Mindfulness is a type of meditation and can come in all different types as it is all about observing and concentrating. Some mindfulness skills work for some, but not others which is completely normal. There are many different apps that can be used for listening and sound mindfulness tasks but you can also eat mindfully, hold something mindfully or even colour mindfully. Depending on the service, the skills can vary but the staple skills within this module include:
  • Wise Mind
  • Observe
  • Describe
  • Participate
  • Nonjudgmental Stance
  • One-Mindfully
Emotion Regulation Skills are a set of skills that can be used to recognise, understand, explain, be more aware and have more control over your emotions. I found these skills in particular helpful when describing how I am feeling. The skills in this category are:
  • Identifying & Labeling Emotions
  • Reducing Emotional Vulnerability
  • Increasing Positive Experiences
  • Opposite Action
  • Coping Self-Statements
  • Identifying Unhelpful Thinking
  • Problem-Solving
  • Sleep Hygiene
Interpersonal Effectiveness Skills are all about teaching you how to both ask for things and to say no to things or other people in a calm manor, whilst also maintaining your self-respect and important relationships, without making situations worse. The skills inside this module are:
  • Clarifying Goals
  • Objective Effectiveness (Dear Man)
  • Relationship Effectiveness (Give)
  • Self-Respect Effectiveness (Fast)
  • Seeing another perspective (Think)
The last set of skills are Distress Tolerance Skills which are probably the ones that I found easiest to learn. These are a set of skills that can be used to teach you how to cope and deal with a crisis in a more effective way, without having to resort to using destructive or harmful behaviours. The skills within this module includes:
  • Distract
  • Self-Soothe
  • Improve The Moment
  • Pros and Cons
  • Radical Acceptance
  • TIPP Skills
I will be doing blog-posts on each different skill and I will leave a page at the top of my blog where each skill will be linked. I will do them in any order, but if there are any that you'd prefer to see sooner then please do let me know.

Thank-you for reading, Tay x


Sources & Links: 
Mind DBT 
Diary Card Example
What to include in a DBT Chain Anaysis
Photo

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