INDIVIDUAL DBT THERAPY SESSION
REMINDER SHEET
I have consulted my target hierarchy so I know what kind of things this patient is tracking on the diary card before they arrive
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I am reviewing the diary card with the patient to see which is the top target behaviour that has occurred since we last met
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I am fixing the exact day and time of the incident of the target behaviour that we will work on in this session
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I am conducting a chain of the events surrounding the target behaviour
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I am paying particular attention to affective (emotion) links
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I am looking for dysfunctional links in the chain
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I am asking ‘what is the function of this behaviour?’
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If the dysfunctional link is a skills deficit I will coach skills
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If the dysfunctional link is problematic thoughts I will coach cognitive modification and mindfulness
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If the problematic link is an unwarranted emotion I will use exposure techniques
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If the problematic link is that the environment is rewarding unskilled behaviour or failing to reward skilled behaviour I will look at contingency management
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I am conducting a solution analysis on a particular link in the chain (I will get more points for choosing the affective links.)
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I am getting the client to ‘rehearse’ the new skill by practicing here in the room e.g. mindfulness or interpersonal role-play, and by getting them to describe EXACTLY what they need to do. (No rehearsal = NO points!)
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If I have not got round to rehearsing solutions by the time there is only 20 minutes left I will STOP my chain analysis and start rehearsing.
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I am weaving in the following DBT techniques: | |
Highlighting secondary targets as patterns of behaviour | |
Using different levels of validation strategically | |
Use of metaphor | |
Looking for what is missed out | |
Using a mix of reverent and irreverent strategies | |
Highlighting dialectical tensions and finding syntheses |