DBT Therapist: A Case Study

Decent Essays
A strength of DBT is that therapists are able to disclose the way that they use skills application to solve problems in their own lives. As a trained DBT therapist, this is a strategy that I utilise regularly with the people I work with, in order to normalise and validate their problems and reflect a sense of personally benefitting from the use of DBT skills. Similarly, MBT therapists are taught to use self-disclosure of their own point of view to enlarge the patient’s perspective of an interpersonal situation, thereby illustrating that there are various ways in which interpersonal events can be interpreted, resulting in more productive or less destructive responses by the patient (Bateman, 2015). Both DBT and MBT incorporate warmth, empathy,…show more content…
All of these therapeutic stances and techniques strive for balance, dialectical thinking, and integration. Given Imogen’s recent suicidal behaviour and her report that her PRN medication was not having the same effect that it once had, I arranged a medication review with the Consultant Psychiatrist in order a medication review with the Consultant Psychiatrist. Imogen was realistic in her attitude towards medication and recognised that it wouldn’t immediately cure for her symptoms; however she was open to having a discussion about her medication options. There is conflicting evidence and recommendations regarding the use of psychiatric medication for people with BPD, as discussed by Bateman et al (2015) in their review of treatment options for people with the diagnosis. They highlight that the American Psychiatric Association recommend that medication should be used to help manage symptoms in conjunction with other non-medical treatments, the most effective being SSRI’s or mood-stabilisers to manage affect instability and low dose antipsychotics to manage perceptual disturbance (Oldham et al, 2001). This contradicts the NICE guidelines for BPD (NICE, 2009) which recommend that pharmaceutical intervention should be avoided,…show more content…
One of Imogen’s primary defences against traumatic stress symptoms is 'attribution'. (reference) This means that she attributes the thoughts, emotions and experiences that she can’t tolerate in her own mind, to another individual. (It is not I that needs you it is you that needs me, It is not I that am angry with my mother it is you that wants me to be). At times I have found myself feeling anxious while working with Imogen and worried that I’m not doing a good enough job supporting her. Upon reflection (both individually and within clinical supervision) I have determined that I am sensitive to (transference/counter transference/attribution) and find it difficult when I am not always held in positive regard, something which is inevitable when working with this client group. Due to my own drive to be effective and please others, I have had to be reflective in my practice and utilise my own coping strategies in order to build the personal resilience required for this role. Sampson (2006) highlights that if services and practitioners take more responsibility than is helpful, it can impact not only on the client’s recovery but also lead to the professional feeling frustrated, stressed and burdened. Without the opportunity to process these feelings, there is the potential
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