1. Dialetical Behavior Therapy (DBT) OT 460 A

2. DBT  Considered to be a form of CBT  Developed by Marsha Linehan  Commonly used with people with Borderline Personality  Also used with people with Depression, Substance Abuse, and/or Eating Disorders  Focus:  Suicidal thoughts and actions and self-injurious behaviors 10/23/2012 OT 460A 2

3. DBT Definitions  Dialetics: represent the mind’s way of understanding concepts by understanding and appreciating their polar opposites (Elliott, C. (2010). What Does Dialectical Mean?. Psych Central. Retrieved on October 22, 2012, from http://blogs.psychcentral.com/anxiety/2010/02/what-does-dialectical- mean/ http://blogs.psychcentral.com/anxiety/2010/02/what-does-dialectical- mean/  Theory: some people are prone to react in a more intense and out-of-the-ordinary manner towards certain emotional situations, primarily romantic, family, and friend relationships  Some people’s arousal levels in emotional situations can increase far more quickly than others, attain a higher level of arousal, and take longer to return to normal levels  (PscyCentral: http://psychcentral.com/lib/2007/an-overview-of- dialectical-behavior-therapy/all/1/ 10/23/2012 OT 460A 3

4. DBT Characteristics  Support Oriented: help people identify strengths and builds on them  Cognitive-based: CBT strategies  Collaborative: Requires constant attention to relationships between client and staff. Clients and staff are encouraged to work out problems with relationships with each other  People role play new ways of handling relationships, strategies to soothe self, and have have homework assignments 10/23/2012 OT 460A 4

5. Four Modules of DBT  Mindfulness: observe, describe, and participate  Interpersonal Effectiveness: similar to assertiveness training and interpersonal problem- solving classes  Distress Tolerance: ability to accept, in a non- evaluative and nonjudgmental fashion, both oneself and the current situation  Emotional Regulation: identifying & labeling emotions; identifying obstacles to changing emotions; reducing vulnerability to the emotional mind; increasing positive events; applying distress tolerance techniques 10/23/2012 OT 460A 5

6. OT Role Assessments that focus on function in occupations and contexts can provide relevant information Interventions: Assertiveness training Coping strategies Interpersonal Skills Groups address acquisition of skills and how they affect occupational performance Must have a strong therapist-client relationship for validation and confrontation 10/23/2012 OT 460A 6