Dialectical Behavior Therapy (DBT) Overview

Introduction

• Presenter: Gloria Scott, Nurse at Johns Hopkins Hospital, Child and Adolescent Psychiatric Unit.
• Aim: To understand DBT concepts and skills for self-care and child support.

What is DBT?

• Purpose: Designed for those with intense emotions and difficulty managing them; applicable for everyone.
• Goal: Replace problematic behaviors (e.g., substance abuse, cutting) with skillful behaviors.
• Outcome: Experience emotions without acting on them, improve relationships and communication, and create a life worth living.

Core Concepts

• Dialectical: Two opposite ideas can be true at the same time.
• Focus Areas:
  • Mindfulness
  • Emotion Regulation
  • Distress Tolerance
  • Interpersonal Effectiveness
  • Walking the Middle Path

Basic Assumptions

• People are doing the best they can.
• People want to improve and need motivation to change.
• Problems may not be self-caused, but need solving.
• No absolute truth or single solution.
• Failure is not possible.

Three States of Mind

• Reasonable Mind: Facts, logic, research, statistics.
• Emotional Mind: Feelings, urges.
• Wise Mind: Combination of reasonable and emotional mind; ideal for decision-making.

Mindfulness

• Definition: Full attention to the present moment without judgment.
• Practice: Can be applied to any activity (e.g., walking, breathing).
• Benefits: Clears the mind, creates new brain pathways, aids decision-making.

Emotion Understanding

• Purpose of Emotions: Provide information, motivation to act.
• Emotions vs. Facts: Emotions are not facts; check facts in situations.
• Example: Daughter's traumatic event and subsequent anxiety; use of factual checks (e.g., video camera).

Emotion Regulation

ABC PLEASE

• ABC: Increase positive emotions
  • A: Accumulate positive experiences.
  • B: Build mastery by taking small steps.
  • C: Cope ahead by planning for stressful events.
• PLEASE: Reduce vulnerability
  • Physical Illness: Treat illnesses.
  • Balanced Eating: Maintain steady energy.
  • Avoid Drugs: Mood-altering substances.
  • Sleep: Stick to routines.
  • Exercise: Regular activity.

Distress Tolerance

• Analogy: Distress is like waves; they come intensely but recede.
• Soothe with Senses: Use sight, hearing, smell, taste, touch to relax.
• Wise Mind ACCEPTS: Distract yourself with activities, contribute, compare, create, and push away thoughts.

Acceptance

• Reality: Some things can't change; learn to accept without additional stress.
• Response Options: Solve the problem, change feelings, accept, remain miserable, or make things worse.

Dialectical Thinking

• Definition: Recognize multiple truths.
• Benefits: Enhances understanding, flexibility, and perspective.

Validation

• Importance: Shows understanding and acknowledgment without judgment.
• Impact: Reduces stress and improves communication and relationships.

Resources

• Apps: Calm, Headspace.
• Books:
  • "Parenting a Teen/Child Who Has Intense Emotions" by Pat Harvey.
  • "How to Talk So Kids Will Listen and Listen So Kids Will Talk."
• Websites: Behavioral Tech.
• Social Media: Trauma-Informed Parent, Big Little Feelings.

Conclusion

• Encouragement to use DBT skills for personal and family support.
• Reminder of the importance of validation and dialectical thinking.