DBT Therapist: A Case Study

This essay intends to introduce the reader to the most important skills involved within developing and maintaining a therapeutic relationship between a client and the therapist or counsellor. The onus will be on Humanistic counselling but many of these skills are central to all counselling types.

My journey to and through CBT training has given me the opportunity to the use self-reflective practice in addressing certain issues within my own life.

MI therapists prize the client when they are with the client. As in Person-Centered therapy, the client is regarded as the expert of his life. Within the client lies the will to change if it can be adequately identified and then encouraged to come out. Once encouraged and heard, the will to change can then be involved in planning a change. Carl Rogers developed a therapy method that trusted the client. His person-centered approach began with the client receiving and benefiting from a special status conferred upon him by the therapist. This theoretical approach pivots around the idea that clients have the ability to

They both have a “positive view of human nature and view the individual as not necessarily being a product of their past experiences, but acknowledge that they are able to determine their own futures” (Holder, 2013). They both attempt to improve their client’s wellbeing by implementing a two-way therapeutic relationship where both client and therapist collaborate to enable the clients coping mechanisms (Holder, 2013). CBT and PCT both instil the three core conditions of empathy, unconditional positive regard and congruence but in CBT it is used mainly in the establishing of the working alliance (Holder, 2013). In both methods, the relationship between client and therapist is congruent and they both use the skills of reflection, paraphrasing and

My role as the clinician is quite important. The primary task is to engage the client in identifying cognitive errors, refuting them, and replacing them with more adaptive thoughts. A sound therapeutic relationship is necessary for effective therapy, but not the focus of the therapy. Many forms of other counseling believe that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but I know that is not nearly enough. We believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT tries and focuses on teaching rational self-counseling skills. CBT is the teamwork that exists between the therapist and the client. This form of therapy is used to seek ways of learning what their clients want out of life and then helping their clients achieve those goals. The therapist's role is to listen, teach, and encourage, while the client's roles is to express concerns, learn, and implement that learning (Pucci1).

Yalom, Y.D. (2009). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients: Harper Perennial

This paper begins with a general idea of self-disclosure by therapists and the importance of keeping the client’s needs first. It covers many aspects of self-disclosure including ethically what to look for in the motives of using self-disclosure with a client. There are other aspects of self-disclosure which include transference and countertransference which are issues which need to be attended to immediately for the therapist to remain objective and not react to a client. Therapists must be cautious in disclosing information and make sure it is relevant to treatment. Beneficence and nonmaleficence are important things to consider when self-disclosing and the therapist must be educated, well trained, and have experience before considering self-disclosure. Also included in this paper are different orientations in relation to self-disclosure. Those orientations include Adlerian therapy, cognitive behavioral therapy, feminist therapy, and relational therapy. Although these are only a few orientations,

How Therapist Self-Disclosure And Non-Disclosure Affects Clients”, stated that, “The study results suggest that therapist self‐disclosure has both positive and negative treatment implications.” It depends on how therapeutic the self-disclosure would benefit the client in that given situation, and the client’s receptiveness to what information is given to them; for example, one patient may respond positively to a therapist’s self –disclosure that reveals another safe point of view of an issue, while another patient might feel that therapist’s has over stepped their boundaries. Madill et al. stated that, “These were sometimes attributed to inexperience and sometimes the characteristics of the total situation, such as events from the therapist's personal life” (13). There are times when sharing something from the therapist can help explain an issue that is present during the time of that therapy appointment. Another problem with a therapist’s self-disclosure is that after years of treatment, the therapist can run out of examples to use to clarify a point made during the appointment. Years and years of treatment sometimes cover issues where the therapist, will add something about himself or herself. People who tend to talk for a very long time during therapy can relate on a level that is not crossing the boundaries. In addition, self –disclosure may be a major problem for therapists who live and work in rural communities, because

During their therapy sessions, patients participated in weekly individual sessions with a trained DBT therapist and a weekly skills training group session. Their individual therapy sessions focused on improving their motivational skills, specifically their motivation to remain in treatment. During their group skill’s training sessions, patients were taught to improve their social skills, self-regulation, mood control, acceptance skills, and self worth. The therapists emphasized the idea of acceptance and validation in the patient in an attempt to return the patient back to normal

approach. Which means that BP disorder has been predominantly treated pharmacologically. Pharmacological treatment of BP disorder is not to be underestimated, but it is also not to be considered the first and last option of treatment. Research has shown that the Cognitive Behavioral Therapy (along with various other treatments) combined with pharmacological treatment has been shown to have better efficacy than each of these approaches separately (Singleton, 2006).

(2014) mentions a 26-year-old girl who is unemployed and was recently referred for admission to a hospital because of her suicidal ideations and strong urges to self-mutilate. When she started therapy three years ago she began to self-idealize her therapist because of the insight and empathy she felt from him (Butcher et al., 2014). She started become hostile and very demanding of her therapist and wanting to meet with him more and some days even wanted multiple sessions a day (Butcher et al., 2014). Her life started to become centered around her therapist and was not able to see it or even control the urges that then led to self-mutilating her forearm with a razor, causing her to being admitted to the hospital (Butcher et al., 2014). With this case there are some very clear evidence that the client is suffering from BPD. The desire for longing and the unstable view of herself led to the desire of acceptance and approval from her therapist. She became very needy and unstable with her moods, when she could not get the attention she needed she would then threaten to cause physical harm to herself which is extremely common in individuals with BPD. The turmoil she was starting to feel with her therapist was a trigger for an emotional

Self-disclosure is one of the five influencing skills used by therapists with their clients. Self-disclosure allows the interviewer to share personal information with their client when necessary. The skillfulness of therapist disclosure has an overarching theme and has the most important and influential factor in client’s perceptions of the helpfulness of their therapists’ responses and contributed toward the development of a positive alliance (Redlinger-Grosse, Veach, & MacFarlane, 2013). Self-disclosure is not the retelling of one’s life story or monopolizing the client’s therapy session. Instead, it is carefully placed information that helps the client realize that they are not alone in the situation they are going through, plus it

It is important that the therapist conduct sessions in a way where they are showing themselves in the session without pretense. This allows a growth-promoting climate with the psychoanalysis of the client’s behavior. An important factor for a successful person-centered therapy allows clients the freedom to develop and control their own lives, rather than being tied to their past (Goodwin, 2008). This method also denotes and consists of psychotherapy theory and humanistic therapy where the concentration is on the present rather than the past, and the humanistic analyst tends to underlines awareness instead of being unaware. Both theories share a common method while patients and clients converse their feelings vocally and the therapist provide analyses.

Fals-Stewart el at. (2004) mentioned that “the therapist’s ability to develop a strong collaborative therapeutic alliance with the partners is essential for successful BCT”. Key therapeutic skills include empathizing, instilling a sense of hope, and working on mutually established goals. The most common clinical barrier to

Biologically focused psychologists would be concerned with the rates of depression, BED, and BPD in Ellen’s family. This information is necessary to understand if it runs in her family or causes her to be more susceptible to it. An approach for treatment would be the use of medications to help regulate the neurotransmitters. There are different options for treatment including antidepressant medication. A commonly chosen treatment is the use of selective serotonin reuptake inhibitors (SSRIs). This medication would be useful for Ellen due to the fact that these medications are often used to help treat eating disorders, such as her binge eating disorder, as well as those with personality disorders, which includes her borderline personality disorder.