--Stay in the present- the client wants to pull the past into present ("Let's look at the calendar, today's date is...)
--Focus on one thing at a time
DBT Involves Two Components
Individual- talk about the previous week
--Discuss self injurious and suicidal behaviors
--Therapy interfering behaviors
--Quality of life issues
--Interpersonal effectiveness skills
--Emotion reuglation skills
--Distress tolerance skills
A set of clinical proceudres relying on experimental findings of psychological research
-Based on principles of learning that re systemically applied
--Treatment goals are specific and measurable
-Focusing on the client's current problems
--To help people change maladaptive to adaptive behaviors
-The therapy is largely educational-teaching clients skills of self-management
In Vivo Desensitization
-Brief and graduated exposure to an actual fear situation or event
-Prolonged and intensive in vivo or imaginal exposure to sitmuli that evoke high levels of anxiety, without the opportunity to avoid them.
-Eye Movement Desensitiziation and Reprocessing (EMDR)
--An exposure- based therapy that involves imaginal flooding, cognitive restructuring, and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders and fearful memories of clients
Psychotherapy is an information processing and uses an eight phase approach to address the experiential contributors of a wide range of pathologies
--It attends to the past experiences that have set the groudwork for pathology
--The current situations that trigger dysfunctional emotions, beliefs, and sensations, and the positive experience needed to embrace future adaptive behaviors and mental health.
EMDR (Slide 2)
During treatment various procedures and protocols are used to address the entire clinical picute
One of the procedural elements is "dual stimulation" using either bilaterial eye movements, tones, or taps
During the reprocessing phases the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external stimulus.
During that time, client's generally experience the emergence of insight, changes in memories, or new associations.The clinician assists the client to focus on appropriate material before initiation of each subsequent set.
Eight Phases of Treatment
The first pahse is a history taking session during which the therapist assesses the clien'ts readiness for EMDR and develops a treatment plan.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state
In phase three through six, a target is identified and processed using EMDR procedures.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client
Although eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens.
After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upton the client's report the clinician will facilitate the next focus of attention.
Four Aspects of Behavior Therapy
-Certain respondent behaviors, such as knee jerks, and saliavtion are elicited from a passive organism
-Focuses on action sthat operate on the environment to produce consequences
--If the environmental change brought about by the behavior is reinforcing, the chances are strengthened that the behavior will occur again. If the environmental changes produce no reinforcement, the chances are lessened that the behavior will recur.
-Gives prominence to the reciporcal interactions between an individual's behavior and the environment
Cognitive Behavior Therapy
-Emphasizes cognitive processes and private events (such as client's self talk) as meidators of behavior change.
Functional Assessment of Behavior (A-B-C Model)
Relaxation Training- To cope with stress
Systematic Desensitization- For anxiety and avoidance reactions
Modeling- Observational learning
Assertion Training-Learning to express one's self
Social Skills Training- Learning to correct deficits in interpersonal skills