Today was all about understanding the dialectics or doing both the acceptance and change of the client’s target (problem) behavior. Unlike CBT, which is focused on change purely, DBT focuses on finding a solution acceptable to both client and therapist that includes both approaches of solving the target behavior called the synthesis.
Then we dived into behavior therapy, specifically operant and classic conditioning. We did understand the positive & negative reinforcement and punishment concepts.
Following this, we did a case specific behavior chain analysis that is essentially a functional analysis of identifying the target behavior, recognizing the precipitating event or the antecedent in general behavior therapy language, in light of that day’s specific vulnerability factors for that client like lack of sleep or hunger etc. It is to be noted that, when identifying the precipitating event, we also want to know what thought & emotion led the client to do the target behavior- the culminating F it moment! These are the key controlling variables we want to track across chain analyses of various events of such critical nature over time. These will show a pattern, that we can then use to reinforce relevant skills that were used during such crises events , as identified as controlling variables. This is a good way to problem solve, is what I understand.
Well that’s it from me on DBT learnings so far ! Enjoy!
If all that I grasped from Miller and Rollnick’s book was how to do affirmations and summaries , I think my day was well spent! I loved the practice of role playing to summarize and affirm case studies of imaginary clients, and it was totally helpful. It put my senses of reflections in perspective and gave me an extra push to recognize strengths, efforts, values and skills in my clients😅 through these attuned reflections, aka affirmations!
Summaries can be transitional , linking as well as collective and can be rendered merely to fill an awkward pause in the conversation or as we are inundated with too much info and all you need is a break to collect your thoughts so far.
Unjumbled my day through this feat!
Enjoy a wonderful evening!
To me Motivational interviewing is the most person centered approach available for a therapist to adapt. I believe I like the rolling with resistance aspect of it the most, knowing there’s nothing worse than entering into an argument with a client or even worse get in to a heated conversation leading into a full blown conflict.
There’s the broader framework of stages of change that helps baseline the approach and introduce the client to a new perspective of what’s ahead of them in this therapeutic alliance.
I am also intrigued by the ability to appreciate and sit with the client during their ambivalence, although there’s a lot of stepping back in progress and sitting in silence of the client through their confusions about why they need to change.
Looking forward to starting a 6-week group therapy curriculum at work based on motivational interviewing soon!