skills development - a treatment for bpd

• dialectical behavior therapy - dbt
• involves coaching
• grp/indiv
• marsha linehan - diagnosed w BPD

targets for treatment

• level 1
  • suididal, parasuicidal, life threatning behavior
• level 2
  • therapy interfering barriers
• level 3
  • behaviors that make it difficult to develop a reasonable quality of life

relationship is often the only reinforcing factor for the client

• experience of genuine acceptance and caring is often new
• communication that the rules have changed
  • if behavior does not improve then the client will lose their therapist
    • paradoxical - often clients are fearful that if they get better the therapeutic relationship will be lost

the dialectic

• acceptance and change

-

• assumptions
  • clients are doing the best they can
  • clients want to improve
  • clients need to do better, try harder, and be more motivated to change
  • clients may not have other own problems, but they are responsible for solving them anyway
  • clients with BPD - lives are unbearable as they are currently being lived
  • clients must learn new behaviors on an all relevant contexts
  • clients cannot fail
  • therapists need support

levels of validation

• be present
• accurate reflection
• guessing about unstated feelings
• validate in terms of past history
• validate in terms of present events and the way most people would react
• radical genuineness

mindfulness

• emotion regulation
• emotional mind
• reasonable
• wise mind

mindfulness skills

• develop a spacious awareness of present moment
• develop a curious, nonjudgmental obervant stance
• notice the transient nature of internal experiences
• beginner's mind (see things through the perspective of a learner, being open)
• what skills and how skills*