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Dialectical Behaviour
Therapy (DBT), developed by
Marsha M. Linehan, Ph.D., ABPP, at the
University of Washington, is a systematic cognitive-behavioural
treatment for
Borderline
personality disorder (BPD) , especially for individuals with chronic patterns
of suicidal or other severe dysfunctional behaviours. Since its
inception, DBT has been adapted as a treatment for other complex,
difficult-to-treat disorders including co-occurring conditions.
Balancing acceptance and change strategies, DBT calls on the patient
and the therapist to accept reality while maintaining a strong and
conscious commitment to change.
Research has shown DBT
to effectively reduce suicidal behaviour, dropout from treatment,
psychiatric hospitalization, anger, and interpersonal difficulties.
DBT also has been adapted to treating substance-abusing individuals
with BPD and shown to be effective for this population.
MULTIPLE-CHOICE TEST QUESTIONS AND
ANSWERS
1. From Linehan's point of view, what is the primary dysfunction of
Borderline Personality Disorder?
A. Attention deficit
*B. Emotion regulation
dysfunction
C. Invalidating
environments
D. Self-invalidation
2. What is the key paradox, or dialectical tension, in treating BPD?
A. Independence vs.
dependence.
*B. Change vs. acceptance.
C. Self vs. other.
D. Vulnerability vs.
invalidation.
3. How are the treatment targets ordered in DBT?
1) Quality of life
interfering behaviors/severe avoidance patterns.
2) Post-traumatic stress.
3) Suicidal and
parasuicidal behaviors and urges;
4) Therapy-interfering
behaviors;
5) Skills (interpersonal,
emotion regulation, distress tolerance, "core" skills).
6) Self-respect.
7) Individual goals of the
client.
A. 1,2,3,4,5,6,7
B. 3,4,2,1,5,6,7
*C. 3,4,1,5,2,6,7
D 6,3,4,2,1,5,7
4. A DBT approach suggests that:
A. Suicidal behavior should be ignored so as to not reinforce it.
B. Suicidal behavior should be punished to stop it.
*C. Suicidal behavior should be attended to in great detail.
D. Suicidal behavior is both a symptom and a cause of most problems
of borderline women.
5. Outcome data from a controlled clinical trial comparing DBT to
treatment as usual (TAU) found:
A. DBT
reduces negative emotions (e.g., depression, anger) but does not
change behavior.
*B. DBT is
effective in reducing parasuicidal behavior, inpatient
hospitalization days, treatment dropouts and anger but is not better
than TAU in reducing depression.
C. DBT
skill training plus standard psychotherapy is as effective as DBT
skill training plus DBT individual psychotherapy.
D. DBT is
better than no treatment for reducing parasuicidal behavior and
inpatient hospitalization days but is not better than standard
psychotherapy provided in the community.
SHORT ANSWER TEST
QUESTIONS AND ANSWERS
A. From Linehan's point of
view, what is the primary dysfunction of Borderline Personality
Disorder and how does it develop?
Answer: The primary
dysfunction is an emotion regulation dysfunction. It is a
result both of biological factors (e.g., genetic, intrauterine,
developmental) and exposure to an invalidating developmental
environment.
B. What is the key paradox,
or dialectical tension, in treating borderline personality
disorder and how is this tension handled in Dialectical Behavior
Therapy.
Answer: The key paradox is
that change can only occur in the context of acceptance, and
acceptance requires change. This paradox is handled in DBT by
combining acceptance strategies and change strategies and
balancing the two in conducting treatment.
C. What are the treatment
targets in DBT?
Answer: 1) Suicidal and
parasuicidal behaviors and urges;
2)
Therapy-interfering behaviors;
3) Quality
of life interfering behaviors/severe avoidance patterns.
4) Skills
(interpersonal, emotion regulation, distress tolerance,
"core" skills).
5)
Individual goals of the client
D. What are
the six levels of the validation strategies?
1. Listening, hearing,
observing accurately what the client thinks, feels, or does.
2. Communicating back to the
client in an accurate manner his/her thoughts (beliefs,
assumptions, etc.), feelings, behaviors.
3. “Reading the person’s
mind”, articulating accurately what is not said.
4. Validating in terms of
the past or in terms of dysfunctional biology.
5. Validating in terms of
the present.
6. Radical genuineness
Download FAQ regarding
DBT
For Health
Professionals
http://www.behavioraltech.com/downloads/DBT_FAQ.pdf
For Consumer Family &
Friends
http://www.behavioraltech.com/downloads/dbtFaq_Cons.pdf
Source: Behavioral Tech
Inc.
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