DialecticalBehaviourTherapy辩证行为疗法.pptx
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1、 GoalTo Build A Life Worth Living第1页/共32页Steps1.Clear Structure2.Do Behaviour Therapy3.Add Validation4.Add Dialectics5.Add Mindfulness第2页/共32页1.Clear Structure第3页/共32页Assumptions About Clients&Therapy1.Clients are doing the best they can2.Clients want to improve3.Clients need to do better,try harder
2、 and be more motivated to change4.Clients may not have caused all of their own problems but they have to solve them anyway5.The lives of suicidal borderline individuals are unbearable as they are currently being lived6.Clients must learn new behaviours in all relevant contexts7.Clients cannot fail i
3、n therapy8.Therapists treating borderline clients need support第4页/共32页Assumptions about Therapy&Therapists1.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 utmo
4、st importance in the conduct of DBT3.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 clients5.DBT therapists can fail6.DBT therapy can f
5、ail even when therapists do not7.Therapists treating borderline clients need support第5页/共32页AgreementsTherapist AgreementsEVERY REASONABLE EFFORT AGREEMENTETHICS AGREEMENTPERSONAL CONTACT AGREEMENTCONSULTATION AGREEMENT第6页/共32页Therapist Consultation AgreementsDIALECTICAL AGREEMENTCONSULTATION TO THE
6、 CLIENT AGREEMENTCONSISTENCY AGREEMENTOBSERVING LIMITSPHENOMENOLOGICAL EMPATHY AGREEMENTFALLIBILITY AGREEMENT第7页/共32页Client AgreementsONE YEAR THERAPY AGREEMENTATTENDANCE AGREEMENTSUICIDAL BEHAVIOURS AGREEMENTTHERAPY-INTERFERING BEHAVIOURS AGREEMENTSKILLS TRAINING AGREEMENTRESEARCH AND PAYMENT AGREE
7、MENT 第8页/共32页2.Do Behaviour Therapy第9页/共32页The consequences of a behaviour affect the probability of the behaviours occurring again.Every therapist response experienced by the client can be neutral,punishing or reinforcing,thus every contingent response is an informal contingency procedure.第10页/共32页
8、Behavioural Assessment There is no substitute for good behavioural analysis to determine what is prompting and maintaining maladaptive behaviour Chain Analysis 第11页/共32页Assess Necessary Intervention1.Are the behaviours in the persons behavioural repertoire?No Behavioural Skills Training2.Are ineffec
9、tive behaviours being reinforced?Yes Contingency Management 3.Are effective behaviours inhibited by unwarranted fears or guilt?Is the person emotion phobic?Yes Exposure4.Are effective behaviours inhibited by faulty beliefs and assumptions?Yes Cognitive Modification 第12页/共32页3.Add Validation第13页/共32页
10、Levels of Validation1.Staying awake unbiased listening and observing2.Accurate reflection summarising3.Articulate the unverbalised emotions,thoughts or behaviour patterns take a slight leap and read beyond what theyve said,may be safer to use a“multiple-choice approach”4.Validation in terms of past
11、learning or biological dysfunction5.Validation in terms of present context or normative functioning6.Radical genuineness being yourself with the client as you are with others,same tone of voice,same language,not stepping into a role第14页/共32页4.Add Dialectics第15页/共32页Dialectics 1-A World View1.The Pri
12、nciple of Interrelatedness and WholenessSystems perspective on reality(identity is relational)2.The Principle of PolarityReality is not static but is comprised on internal opposing forces out of which synthesis is achieved.“Contradictory truths do not necessarily cancel each other out or dominate ea
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