DBT Therapist: A Case Study

Having been recently introduced this style of therapy, I became curious to apply my newfound knowledge during the first session with my new client. Like most people, I learn best by doing. The literature that I have read describing MI has not been as descriptive of a real-life session as I would like for it to be. So, closely observing how a counselor guides a conversation with a client, paying meticulous attention to body language and nuanced facial expressions, has been tremendously helpful in my understanding of how these kind of interventions can

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.

The foundation of therapy starts by building rapport with the client and applying strategies when necessary to overcome a variety of barriers. It is imperative to have rapport with a client and to be aware of barriers to facilitate a good treatment outcome. This will take practice and the use of methods and strategies ready to be implemented when needed. There are many components to building a good client rapport such as: intimacy, vulnerability, exploration of inner challenges, self-awareness, staying present; inner resiliency, empathy, anxiety management, and self-integration, and relationship acceptance. The two types of barriers are internal and external and this is for both the client and the therapist. The common barriers to rapport are countertransference and transference. Strategies for overcoming barriers are: Pause Moment and self-awareness. It also requires skills such as being genuine, sensitive, open, and

Most of the participants were recruited from the greater Aarhus area in Risskov. Potential subjects completed clinical interviews, state examinations (PSE) (SE) and semistructured SCID-II interviews. 111 participants took part in the study and all met the DSM-IV diagnostic criteria for BPD. In order to participate in the study, the participant must be older than 21 years old, the patient could not have co-occurring conditions such as antisocial and paranoid personality disorders, if a patient were suffering from a severe substance abuse problem (every day) they were excluded, and the individual must have a global assessment of functioning (GAF) score above 34 to be included for randomization.

DBT is a structural approach to counseling that incorporates several therapy approaches to include: cognitive behavioral therapy, client-centered, psychodynamic, gestalt, paradoxical and strategic. The combination of these approaches is incorporated by four empirically supported techniques designed by Dr. Marsha Linehan.

The aspect of BPD that drew me towards it was the notion that it is a more widespread mental illness than people think, often tied down to difficulties in diagnosing it due to crossovers with other illnesses such as depression which uses similar diagnosis criterion from the DSM V. In fact BPD affects 50% more people than Alzheimer’s disease and nearly as many as schizophrenia and bipolar combined (2.25%). There are a number of treatments available including new advances in epigenetics meaning a potential for more effective medication, as well as ' talking therapy ' treatments such as schema based therapy, metallization therapy and dialectal behaviour therapy which I am going to evaluate in order to decide according to scientific evidence and application what the most effective treatment for BPD is at present. The most effective treatment will be decided upon a

The use of compliments in SFBT both helps the client to feel confident in themselves and in what they are doing as well as helps to discover strengths the client possesses. Compliments should not be used by the therapist as a method of being kind to the client rather they should reality based and derived from communication that is taking place during therapy (DeJong and Berg, 2013). The use of compliments as a technique in clinical situations is preferable as it provides the client with immediate positive feedback reinforcing the client’s efforts to change. A potential risk to using compliments in therapy is that when given or received compliments may feel awkward for all individuals involved. Additionally, a risk of giving compliments is

Many medical professionals initially suggested that BPD overlapped with schizophrenia, non-schizophrenic psychoses, and neuroses such as anxiety and depressive disorders. Due to what appeared to be it’s overlap with so many other psychiatric diagnoses, it became known as a “wastebasket” diagnosis. Oliver Bonnington writes; because patients did not fall clearly into specific diagnostic category researchers believe testing lacked diagnostic precision and validity. It also was thought that the disorder responded very poorly to treatment. Yet modern day studies have shown differently. Borderline treatment relies primarily on psychotherapy with medications

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

It is also important to note that people with BPD suffer high rates of co-morbidity. Borderline personality disorder rarely stands alone. BPD occurs with, and complicates, other disorders. According to the National Alliance on Mental Illness (NAMI), 60 percent of those with borderline personality disorder also suffer from major depressive disorder. Also, another 35 percent have a substance abuse problem. Integrated treatment is a unified and comprehensive treatment program for dual disorders. In order to treat a client with BPD, all disorders and issues need to be

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

Therapeutic use of self involves using one’s personality, body language, active listening that is used to create and maintain a therapeutic relationship with others (Lowe et al., 2007). Establishing trust is also an important aspect of therapeutic use of self, to address the needs and goals of the client, which helps our scope of practice to remain client-centered. Using therapeutic use of self is beneficial for occupational therapists (OT), as it facilitates interaction with the client. It also encourages and allows the therapist to obtain necessary information, and to alleviate fear or anxiety that may take place during treatment session. During Level I Fieldwork at a SNF, I was able to apply these principles during a treatment session for a client diagnosed with dementia that was agitated and non-compliant with the activity. To divert her attention to the activity, and to get her to understand that I was

There are many values this writer wishes to incorporate into a counseling relationship. The fundamental values this writer wishes to incorporate are: flexibility, self-awareness, self-regulation, and empathy. The ability to be flexible and alter what one does in order to fit the client’s needs is crucial to establishing and maintaining a therapeutic relationship. Flexibility can be demonstrated in many different ways, such as the way the therapist interacts with the client, the tone of voice that is utilized, down to the way the therapist provides material to the client. In being flexible, treatment is able to remain focused on the client and his or her needs (Egan, 2014).

There are different therapies that are used to help treat those who have suicidal ideation, behaviors, and attempts. For individuals to be successful in recovery one or more treatments may be necessary. Succession of recovery is a group effort and wiliness between individuals, family, friends, psychiatrists, and therapists. A traditional anti-depressive medication treatment is started to help reduce negative thoughts (Rovick, 2016). These medications increase serotonin levels in the brain to increase happier thoughts. However; depending on the individual, multiple medications are prescribed to target each symptom displayed. In some cases mood stabilizers or anti-psychotics are needed in correlation with the anti-depressants. Individuals with depression and PTSD are prescribed a SSRI and a medication to target the PTSD. Medications do not work quickly, the average time for depressive

The main focus of this essay has to be on the three ‘core conditions’, as utilised by the counsellor to promote a positive movement in their client’s psychology. They are intended for maintaining a focus on the client’s personal growth, and detract from the therapist’s own outside world. The three core conditions are the professional apparatus or tool-kit of the therapist, and the use of each is a skill in itself but the combined forces of all three in an effective manner requires an abundance of skill or experience. These are, as have already been mentioned, congruence, unconditional positive regard and empathy. They are separate skills but are intrinsically linked to each other. If used correctly, they can guide the client to a state of self-realisation, which could lead to the development of a healing process.