dialecticalbehaviourtherapy辩证行为疗法.pptVIP

Dialectical Behaviour Therapyin Perth North Metro Area Margaret Cole 11th July 2006 Goal To Build A Life Worth Living Steps 1. Clear Structure 2. Do Behaviour Therapy 3. Add Validation 4. Add Dialectics 5. Add Mindfulness 1. Clear Structure Assumptions About Clients Therapy 1. Clients are doing the best they can 2. Clients want to improve 3. Clients need to do better, try harder and be more motivated to change 4. Clients may not have caused all of their own problems but they have to solve them anyway 5. The lives of suicidal borderline individuals are unbearable as they are currently being lived 6. Clients must learn new behaviours in all relevant contexts 7. Clients cannot fail in therapy 8. Therapists treating borderline clients need support Assumptions about Therapy Therapists 1. The most caring thing a therapist can do is help clients change in ways that bring them closer to their ultimate goals (unwavering centredness) 2. Clarity, precision and compassion are of the utmost importance in the conduct of DBT 3. The therapeutic relationship is a real relationship between equals (there are differences in expertise but no arbitrary power differential) 4. Principles of behaviour are universal, affecting therapists no less than clients 5. DBT therapists can fail 6. DBT therapy can fail even when therapists do not 7. Therapists treating borderline clients need support AgreementsTherapist Agreements EVERY REASONABLE EFFORT AGREEMENT ETHICS AGREEMENT PERSONAL CONTACT AGREEMENT CONSULTATION AGREEMENT Therapist Consultation Agreements DIALECTICAL AGREEMENT CONSULTATION TO THE CLIENT AGREEMENT CONSISTENCY AGREEMENT OBSERVING LIMITS PHENOMENOLOGICAL EMPATHY AGREEMENT FALLIBILITY AGREEMENT Client Agreements ONE YEAR THERAPY AGREEMENT ATTENDANCE AGREEMENT SUICIDAL BEHAVIOURS AGREEMENT THERAPY-INTERFERING BEHAVIOURS AGREEMENT SKILLS TRAINING AGREEMENT RESEARCH AND PAYMENT AGREEMENT The consequences of a behaviour affect the p