Behavior Theory: DBT Clinical Demonstration

come on in okay hey Larry are you doing today oh okay alright but before we get started I just wanted to tell you how proud I was a blue and group on Friday night yes that you really really helped Debbie in the role play I am your boss yeah who's that fuzz it's kind of reverse roles like that you know so I just wanted to tell you that you know the whole group appreciated and you did a great job thank you okay all right well I gotta say you look a little agitated yeah well my mother's been bothering me so much about you know all the chores and the laundry and the dishes okay I just can't stand it I'm so busy looking for a job okay oh well I tell you what then before we get started in our session let's go through just a real quick breathing exercise just to kind of bring you into the here and now okay you're not where you were an hour ago you have to worry about an hour from now that's just kind of right here okay can we do that we've done this a couple times in grooving in those practice it now it's sufficient being on the floor there we go put your hands on where you're comfortable you sitting up straight you've comfortable closing your eyes yes yes all right so let's not clench your hands you go first thing you're going to do is take a nice deep breath and you're going to blow it out slowly through your lips just like you're blowing out the candles on a birthday cake but very slow again to feel the air drove into you sensation on your lips your Grandpa's always your breath is there always there for you to remember that's better you're here and throw it say everything's good so let me ask you question yeah you gonna bring me something or find something oh that's right oh I found something that you could touch your hole oh that's beautiful okay so what do you what do you do with it well this I mean I sometimes I put it just so I can feel it on the back of my neck sometimes I put it in my lap okay you feel better just you know familiar things oh that's right so we'll go ahead and keep in your lap now you can touch it and help keep you singers and keep you here okay so now that your little calmer let's talk about what happened with mom before you came here this afternoon okay well I mean she knows that I'm looking for a job and she knows that I'm going to school and just every time I walk in the door she asks me to do the dishes no matter what and I just we get in a huge argument over well you've been home for two more hours and I've been home so why didn't you do the dishes or why didn't you start the dishes and and we scream at each other and I scream we have screaming matches I always try to scream louder than her and then she gets upset alright so it's back and forth in the situate a situation escalates and you slam doors and we slam doors and stuff how do I get the impression okay well let's use this situation that has happened to you because today I wanted to actually work on awesome interpersonal would give them and I have a handout sheet to give you and it's called the give technique I want you to take a look at this handout you can take that home with you we're going to talk about this we can directly apply this to what happened today with your mom because this is going to happen again right same situation with your mom so it's a it's a an acronym give giv e why don't you read what those letters stand for okay G gentle be gentle I interested act act interested the validate e easy manner use amazing manners okay so this is just something that when a situation starts to escalate you can just say give okay gentle the interested validate and use an easy manner folks it's something it's really short and quick so in your situation with your mother when she started yelling at you about doing stuff if you thought okay G how would that look G gentle um like it not yellow I could be quieter okay maybe your tone of voice so if you thought gentle that would probably stop in your tone of your voice a little bit and that would be a good response okay okay that's very good good what about act interested I'm going to make eye contact with her okay that's important so she knows that you're listening the intention that you're paying attention right okay that would be something that you could do quickly and easily okay and what about validate it's an interesting word what what might that how might you validate what your mother is saying I'm I can tell her that I understand that she would like me to help out around the house yes because you know what if you live together is it important that you work together and get everything done nobody likes to do housework but you all have to do it so does she have a good point yeah can you validate what she's saying that that you do hear what she's saying it's important that you do these things and you know I know that you have a lot on your plate certainly your mother notion have a lot on your plate Taylor right okay you're dealing with a lot so but you can still validate her concerns - okay in an easy manner what would that look like for you um I I mean I kind of aggressive so I guess that could be you know I tried be more light-hearted about the situation if we start getting in arguments like it if we try to tell a joke there's no way I was like and they kind of difficult to tell a joke in the middle of a heated situation its Butthead but yeah you could you could slow down okay slow down and maybe stay calm and just think that think of the letter e easy whatever that that word easy would make you feel okay so what are the three what the four letters again G I G for gentle interested validate easy easy okay good good good good so you're going to take that home and you're going to look that over all right okay put that go ahead and put that it yeah in your workbook so it's a it's a really easy acronym to remember speaking of acronym I used the stop technique that you taught me you did yeah I want to hear about the other day oh happy yep the other day I was in traffic and I was getting on the highway and nobody was letting me in you know everybody was cutting me off I was getting so nervous and anxious because I couldn't get on the highway and then what was going to happen if I couldn't get on the highway and I am with a panic attack oh and I calmed myself down I stopped stopped is the S yeah I stopped I took a breath T you took it breath and kind of like took a step back okay observe my observe situation I said if I can't get on my Highway I'll just get off I'll get off and then I can get right back on and then P I proceeded with driving oh well I'm so I'm thrilled I'm so happy and it was quick and easy to remember yes yes how did I make you feel to be able to change a behavior like that because ordinarily you would have been cursing and having that anxiety attack right I was trying not to do all those things so I thought you know it to stop I just have to it kind of took me over I took it changed my focus and I had that to focus on so I didn't actually stop in the middle the highway but I you know I am so proud of you that is awesome Taylor think I am just that couldn't be happier and wait till we tell the group oh yeah that is no good that would be so good so one more thing I want to give you today one more tool of your little toolkit it's called the opposites and it actually it's in your workbook if you look on page 233 got it if I know anger is one of your emotions that we're working on when I'm is one of our targets here and this has to do with the opposites and you can actually use some of these opposites when you're doing the give technique or when you're doing the stop technique and what it is is that whatever it is that you ordinarily do in response to situations how you react you do the opposite ok so we're going to practice this we're going to practice more a group but I want you to kind of get an idea of what it is today so let me ask you a question when you feel angry what do you usually do with your hands yes yeah kind of tight balled up tan right so what would be the opposite of that out to anyone relax we laugh okay so that would be the opposite of that okay so when you feel like going like that okay or or just keep your hands open okay all right let's see what says your stomach muscles in your chest when you're angry what does that feel like usual it kind of punched over tight i hunched over so if you want to do the absolute opposite of that what would that look like sitting up straight stomach relaxed like I'm taking a deep breath deep breath deep exactly it's hard to take a deep breath when you're like that okay good that's good good good okay what about your face what if what happens when you're angry you're G you're I clench my teeth you can let your two together and you know Brown in and tight so what would be the opposite of that relaxed thanks maybe a little maybe a little smile two little eyes you're up to it nothing fake but this is all meant to be behaviors that you do on purpose so maybe you feel yourself like this you can do it all at once okay and that's something you can choose so got a lot here that you're in your little toolkit for one session so I want you to add this to your homework list okay go ahead and write this down okay I want you this week to make a list in your journal of the times that you've used your stock technique you've already used at one so go ahead and you can put that could be your first entry okay when you used your gift technique hmm and when you use the opposites of a happening and what I want you to do is first put what preceded what that was happening before you decided to use it for this technique so whether it was an argument your mother or somebody cut you off you know you're getting stressed about a homework assignment whatever happens to be what happened before which behavior you choose to use which skill set you're going to implement and then how do you sell afterwards okay and it made you feel calmer happier got along better with your mother you were able to finish your assignment without anxiety that whatever that happened to be okay and I also want you to at least once a day do your breathing technique okay okay even if it's just for one minute just to bring you back into the here and now just to bring you into the present and to know that you can breathe and your breath helps you to remain calm okay sounds good all right it seemed very different than when you walked in here half an hour ago so it's um it's good I'm happy for you to it you're making progress I am very excited for you okay I love your little first scarf ever wish I had one just like it oh okay okay go do some good work I'll see you in group okay on Friday night okay all right thanks thanks bye Irvine okay so what you guys just saw was an example of behavior theory therapy so because behavior is learned it can be changed and we can define it and it consists of behaviors that are observable that we can change also so the patient has a history of self-harm substance abuse um we interpret interpersonal relationships with her family her friends in at work and also school is very stressful and overwhelming for the patient because she cannot focus and she sometimes even have to retake classes so everything is so overwhelming for her right now at this point um so the therapist has been working with her in order to help her to change some of her behaviors she the therapist wants her to increase the serval behaviors to decrease undesirable behavior and improve life in general functioning and to do that the therapist changed the therapist was using changed targets for the patient and those targets or ability to self-soothe increased tolerance for distress improve interpersonal relationships and regulation of emotion yes in the video we were able to watch the four modules of the skills training part of DBT which are the core mindfulness skills the distress tolerance the skills the interpersonal effectiveness of skills and emotional regulation skills mindfulness was demonstrated when the therapist actually did the breathing exercise with taylor by helping her focus in the present in the now in the moment without any judgment the idea was for her to be able just to focus on the session in that precise moment and she was able to be on to demonstrated that skill with taylor and then we she moved on to the distress tolerance skills and she did she did a demonstration of these by doing this stop acronym which ii was basically to stop take a breath observe and then proceed actually it this technique helped taylor to self-soothe so she was able to control her agitation and instead of letting herself feel overwhelmed by all these bathtubs that were going to happen on the road she was able to proceed at the end to continue driving and notice that she did it in the past you could do it again and nothing horrible was going to happen to her then she moved on to interpersonal effectiveness skills and she demonstrated the therapist demonstrated these part of the skills by doing the gift acronym when they interacted about the mom situation at home in taylor she was able to teach taylor to manage the situation in a gentle manner to be interested towards mom you know her feelings too were important not only taken earth to validate mom and use an easy manner to talk to mom and then finally the emotion regulations and still on the Turkish was able to make Taylor understand the function of emotion and she did this by doing the opposite when she actually maintained her us and I actually asked Taylor for examples of what she felt angry and trying to understand her emotions in the physical aspect and then trying to either physically instead of doing this she could just do like that and she actually demonstrated different techniques doing the opposite of what Taylor felt independent the first place and in summary I noticed the therapist used empathy towards the client and a lot of positive reinforcement yes she did and we definitely think that DDT will definitely work for this a specific client one more thing before I forget um it can be possible that Taylor will need to go through the whole cycle probably a few more times so that she can really really learn the techniques and you can take him in my take about a year but eventually we think Taylor is going to be very successful thank you you

Channel: Lisa Mansell

Views: 208,893

Keywords: Behavior Theory, DBT, Dialectical Behavior Therapy

Id: _gPcDRVALVo

Length: 20min 9sec (1209 seconds)

Published: Mon Oct 31 2016