Dialectical Behavior Therapy Skills Training Workbook3

Dialectical Behavior Therapy Skills Training For Emotion Dysregulation Student Workbook Rachel Gill

Table of Contents TABLEOFCON ONTENTS

2

PREFACE

5

I NTROD ODUCTI ONTODBTPEER CONNECTI ONSSKI LLSTRAI NI NG

6

SKILLS TRAIIG !"#RSE "$ER$IE% DBT 'EER !"DE "F !"D#!T +SREG#LATI" T)E BI"S"!IAL *"DEL F"R E*"TI" D +SREG#LATI" DBT %ISE *ID )AD"#T TI' !RISIS S#R$I$AL SKILLS )AD"#T . S TRATEG+ TRATEG+ %"RKS)EET ITR"D#!TI" T" TR"D#!TI" T" DIALE!TI!AL BE)A$I"R T)ERA'+ $IDE" . 0#I1 DBT DIAR+ !ARD / SETTI NG PERSONALGOALS&MAI NT AI NI NG MOTI VATI ON

S*ART G"ALS $ITALS SKILLS S*ART G"AL $ITALS %"RKS)EET DBT & LE$ELS "F $ALIDATI" )AD"#T DBT & LE$ELS "F $ALIDATI" %"RKS)EET DIAR+ !ARD %EEK 2 2

& ( , // /2 /3 15

/& /& /( /, /24

COREMI NDFULNESSSKI LLS

21

5%)AT6 SKILLS 5)"%6 SKILLS *IDF#LESS8 A DAIL+ 'RA!TI!E *IDF#LESS SKILLS %"RKS)EET DBT DIAR+ !ARD 7

2/ 27 29 2& 2(

REALI TYACCEPTANCESKI LLS

28

RADI!AL A!!E'TA!E #R T)E *ID T#R T)E %ILLIGESS %ILLF#LESS RADI!AL A!!E'TA!E RADI!AL A!!E'TA!E %"RKS)EET REALIT+ A!!E'TA!E SKILLS 0#I1 IDF#LESS T" %ILLIGESS . %ILLF#LESS %"RKS)EET *IDF#LESS T" L"$IG K IDESS IDESS DIAR+ !ARD %EEK 3 3 DI STRESSTOLERANCESKI LLSOVERVI EW 2

2, 2, 2274 7/ 72 73 79 7& 37

ST"' SKILLS TRATEG+ + %"RKS)EET ST"' SKILLS S TRATEG A!!E'TS SKILLS A!!E'TS SKILLS %"RKS)EET I*'R"$E SKILLS )AD"#T I*'R"$E SKILLS %"RKS)EET *AKE A SELF:S""T)E K IT IT )"*E%"RK DIAR+ !ARD %EEK 9 9

7, 734 3/ 32 37 39 3&

EMO MOTI ONREGU GULATI ONSKI LLS

47

IDETIF+IG; LABELIG . F#!TI"S "F E*"TI"S * +T)S AB"#T E*"TI"S )"*E%"RK DIAR+ !ARD %EEK & & CHECK THEFACTSOFEMO MOTI ONALRESPON ONSES

!)E!K T)E FA!TS %"RKS)EET DIAR+ !ARD %EEK ( (

3( 3( 350

92 97

OPPOSI TETOEMO MOTI ONACTI ON

54

"''"SITE A!TI" )"*E%"RK %"RKIG %IT) 'RI*AR+ . SE!"DAR+ E*"TI"S DIAR+ !ARD %EEK , , BEHAVI ORCHAI NANAL YSI S&SOL OLUTI ONS

DES!RIBIG LIKS . GEERATIG SKILLS S"L#TI"S )EAD T" 'RE$ET F#T#RE TARGET BE)A$I"R !"'IG A)EAD T" DIAR+ !ARD %EEK ABCPLEASESKI LLS

9& 9( 9, 59

&4 &2 &7 64

AB! SKILLS 'LEASE SKILLS AB! 'LEASE )"*E%"RK DIAR+ !ARD %EEK /4 /4

&3 &9 && &(

I NTERPERSON ONALEFFECTI VENESSSKI LLS

DEAR *A GI$E FAST %"RKS)EET DIAR+ !ARD %EEK // //

68

(/ (7

COU OURSEREVI EW

74

'ERS"AL 'EER E*'"%ER*ET 'LA DIAR+ !ARD %EEK /2 /2

(9 (&

7

DBTRESOURCES

77

DBT S*ART ')"E A''S RE$IE%S

((

GLOSSARY

86

AP PENDI X

88

DBTPEERCONNECTI ONSCONTACTI NFORMATI ON

89

3

Preface %hen Dr< *arsha Linehan; the =oun>er Dialectical Behavior Therapy ?DBT@; recently came out aout her struggles in youth ith suici>e an> psychiatric institutionaliCation; having similar eperiences in my li=e; it cause> me to realiCe that ust as my mental health prolems coul> >estroy me; so coul> they e my re>emption< Thus; I as inspire> to =ollo Dr< Linehans vo to help others n> a ay out o= hell an> am on my ay to ecoming a DBT researcher an> practitioner so that I may learn an> teach others ho to uil> lives orth living through DBT ust as Dr< Linehans ork has >one =or me< Some may think that having the lael o= or>erline personality >isor>er ?B'D@ is a mark o= shame; >isparaging those ho ear the >iagnosis y the implicative nature o= the term or>erline itsel=; ut I can honestly say that receiving the >iagnosis o= B'D as one o= the est things that ever happene> to meeep >on that there as more to my emotional health than ust the >epression >iagnosis I receive> at /7 then /3 at a chil>rens psychiatric ar>; an> then the slue o= therapists that treate> me eteen the ages o= /3:23< In =act; I as so appreciative hen I receive> the B'D >iagnosis that I >i> something that o=ten puCCles those aroun> me hom I tell my storyiagnose> me ith B'D a ouHuet o= oers an> a thank you car>< *y B'D lael is the key that unlocke> the >oor to DBT an> my path to recoveryerline personality >isor>er; ut or>erline personality >isor>er >oes not have me; an> aove all; I am not ashame>< In =act; I am Huite prou> o= the har> ork I have >one can see e ith B'D are not monsters; ho nee> to e controlle>; e are people in nee> o= support; compassion; an> treatments that ork< < Love an> kin>ness; Rachel Gill ?aka 'inki Tusca>erro@ DBT 'eer *entor; B'D 'eer A>vocate; email8ilove>tJgmailt
9

Introduction to DBT Peer Connections Skills Training Skills Training Course Overview This orkook is a comprehensive sel=:help orkook =or learning >ialectical ehavior therapy skills =rom a peer perspective< Session Time Management = !" #ours Per Session Hour 1

= Watching Videos, Reading

Hour 2

= Doing Homework, Discussion & Quizzes

$ Training Sessions = %& 'ours Core Mindu!ness "ki!!s Distress #o!erance "ki!!s $motion Regu!ation "ki!!s %nterersona! $ecti'eness "ki!!s Course Re'iew

( weeks 1 weeks ) weeks 1 week 1 week

Time for Completion 12 weeks or 30 hours

Weekl( Sessions Outline !ore *in>=ulness Skills / Intro>uction to The Bio:social *o>el; %ise *in> . TI' !risis Skills 2 S*ART Goals . $ITALS Skills . the & Levels o= $ali>ation 7 !ore *in>=ulness8 %hat an> 5)o6 Skills 3 Reality Acceptance Skills8 Turn The *in>; Ra>ical Acceptance; %illingness; Loving Kin>ness Distress Tolerance Skills 9

ST"' A!!E'TS an> I*'R"$E Skills

Emotion Regulation Skills & ( , /4

I>enti=y; Lael an> Function o= Emotions !heck the Facts o= Emotional Responses "pposite to Emotion Action =or #nustie> Emotions 'rolem Solving Emotions . Behavior !hain Analysis AB! 'LEASE Skills

Interpersonal EMectiveness // DEAR *A GI$E FAST Skills /2 DBT Skills Revie . 'ersonal 'eer Empoerment 'lans &

DBT Peer Code of Conduct / Group memers agree to >o the est they can an> to ork har> to >o etter< 2 Group memers agree that they have een in=orme> that this program is not oMere> in a pro=essional capacity; ut =rom sel=:i>entie> peers in mental health recovery< 7 This program >oes not mean to replace Hualie> mental health care services 3 Group memers agree to complete the course< 9 Group memers agree to allo their non:personally i>enti=ying in=ormation to e use> =or the purpose o= research an>or improving the course< & Group memers agree to keep >iscussions relate> to skills training an> ill e respect=ul in interacting ith one another< ( 'rolem ehaviors hether they e relate> to sel=:harm; sustance use; eating >isor>ers; etc< shall e re=erre> to generically in group as Target Be'avior or TB< , Group memers shall respect the privacy o= =ello memers an> ill not reveal to others outsi>e the group any in=ormation aout other memers that oul> violate privacy or trust< - Group memers shall re=rain =rom =rien>ing each other outsi>e o= group hile completing skills training in or>er to preserve the unity o= the group< /4 I= a memer has a prolem ith another group memer that cannot e resolve> >irectly; heshe ill >irect concerns to the group lea>er or co: lea>ers through the Lets talk =unction< // The group is a non:u>gmental space =or learning an> sharingN e use min>=ulness to practice a non:u>gmental stance toar> each other; the orl>; an> ourselves< /2 I= group memers =eel suici>al; they agree to seek help e=ore acting on urges< +ou agree to seek help =rom =rien>s; =amily; or y calling the =olloing numer =or the national suici>e hotline< /:,44:2(7:TALK ?,299@

(

T'e Biosocial Model for )motion D(sregulation Emotion Dysregulation is a >ys=unction cause> y a transaction o= incompatile iological an> environmental =actors ithin the emotion regulation system< T he primary iological =actor is emotion vulnerability, hich consists o= Huick; strong; an> long:lasting emotional reactions< The environmental =actor consists o= an invalidating rearing environment , hich >oes not acknole>ge or teach the emotionally vulnerale chil> ho to manage intense an> or >iOcult emotions<

)motion D(sregulation *s! )motion +egulation 'eople ith emotion >ysregulation ten> to eperience emotions more intensely an> longer average people< !onsi>er the =olloing chart; hich shos a compare> to a person ith a more eMective system o= emotion regulation<

Generic example of how a person with emotion dysregulation may respond to an emotionally arousing event

,

DBT Wise Mind #andout Everyo>y has a logical min> an> an emotion min>< %hich si>e o= min> oul> you say that you lean more toar>; the logical si>e or the emotional si>eP Do you trust the =acts or your gut in an important situationP

,ogical Mind - )motion Mind = Wise Mind The goal is rst recogniCe that oth states o= min> are eHually vali> an> then to strive to achieve a alance> perspective =or each state o= min> across situations so that you can learn to e eMectively rational an> min>=ul

-

TIP Crisis Survival Skills Overview Temperature Intense 'hysical Action Pace> Breathing TI' stan>s =or Temperature, Intense physical activity, an> paced breathing< These skills ork y ay o= the o>yQs senses< In the case o= emotions; they are not simply 5in your hea>6 ut part o= a =ull system response< This means that hen an emotional eperience occurs; there is a mo>e o= action< These actions may occur ith or ithout our aareness< ?See Graphic Belo<@ For eample; hen angere> your circulatory system respon>s y increasing your rate an> raising your o>y temperatureN the o>y respon>s to the anger

)vent



)motion



Bod( .uto +es/onse



)motion .ction 0rge

ithout conscious action< The i>ea ehin> the eMectiveness o= TI' skills is that ust as the o>y respon>s to emotions so >oes our emotions respon> to our o>y< ?See graphic elo<@ There=ore; the premise is that y tipping the o>y chemistry; so to speak; e can shi=t prolematic emotional responses< %hat is more; the =act that TI' skills reHuire little logical reasoning makes them easier to apply =or those ith limite> skills training< The =olloing page contains a han>out an> strategy orksheet< The han>out >enes each o= the TI' skills; generally an> then oMers eamples o= ho to apply them< The orksheet >irects you in ho to create a personal TI' crisis skills strategy an> apply it< +ou shall apply your TI' skills strategy the net time you notice you are ecoming emotionally >ysregulate>< +ou ill recor> your level o= >istress on a scale o= 4:/44 e=ore an> a=ter applying your )vent



)motion



TIP Bod( +es/onse

/4



+educe )motion .ction 0rge

strategy< 1OT)2 If at rst you do not succeed in reducing your distress, adjust your TIP strategy as necessary until you nd the right plan that suits you best.

//

TIP Crisis Survival Skills #andout 3 Strateg( Works'eet Temperature Intense Physical Action Paced Breathing T!P"AT#" Do something that shits *our +od* temerature #ake a co!d "hower "!ash co!d water on *our ace, kee an ice ack in the reezer -se a an % it is co!d outside, go outside to !itera!!* coo! o #hink o other wa*s *ou can #%. *our +od* temerature

I$T$% P&'%ICA( ACTI)IT' Do something that gets *our +od* in'o!'ed in intense h*sica! acti'it* #he concet is that when emotions romt the +od* to resond automatica!!*, articu!ar!* in the case o ear or anger, the s*stem acti'ates 'arious chemica!s in the +od* !ike adrena!ine that reare *our +od* to act /uick!* .h*sica! acti'it* acts to e0end this energ* so that ro+!ematic urges to act hoeu!!* reduce Doing things !ike going to the g*m, c!eaning the house, or doing 1 uming acks are e0am!es #hink o other wa*s *ou can #%. *our +od*3s +od* chemistr*

PAC* B"AT&I$+ Remo'e *ourse! rom immediate distractions or a ew minutes to take ten dee s!ow +reathes 4ou cou!d a!so sa* Wise as *ou inhale then Mind as *ou exhale. #hink o another aced +reathing strateg* that ma* work or *ou 5 ke* oint to remem+er is that aced +reathing works +etter the !ess distressing cues there are in *our immediate en'ironment #o gi'e *ou some e0am!es o how to remo'e these cues, *ou might !ea'e the room to get awa* rom a con!ict whi!e *ou +reathe, turn o, and6or mute the te!e'ision, radio, or other distracting sounds % there is noise *ou cannot escae, !ike a +arking dog, tr* +!ocking it with white noise +* turning on a 'acuum or going into the +athroom and turning on the an

,-"!#(AT A TIP %.I((% %T"AT+' $ame/

*ate/

7ow that *ou know what #%. ski!!s are, think o some wa*s *ou can #%. *our +od* chemistr* using each one o the ski!!s, 7e0t time *ou notice *our emotions are getting intense or *ou ha'e an e'ent that *ou need to aroach that is emotiona!!* arousing, a!* *our #%. ski!!s strateg* 5terwards, i *our strateg* is ineecti'e, adust *our strateg* and kee a!*ing them unti! *ou ind the tasks that work or *ou Before "ate *istress on a sca!e o 8 #%. "ki!!s 1 Wa*s % Can #%. M* Resonses with T!P"AT#"

After #%. "ki!!s

1 2

Wa*s % Can #%. M* Resonses with I$T$% P&'%ICA( ACTI)IT' 1 2

/2

Wa*s % Can #%. M* Resonses with PAC* B"AT&I$+ 1 2

/7

Introduction to Dialectical Be'avior T'era/( *ideo 3 4ui5 ISTR#!TI"S8 %atch the vi>eo !T Peer "onnections # Introduction to ialectical !ehavior Therapy by $achel Gill at http8youtu<eTB*&"+is! on +ouTue an> then complete the =olloing HuiC to revie key points< /< %hich item has DBT not proven to e eMective in treating; accor>ing to the researchP A

Suici>al Behaviors

B

Binge Eating Disor>er

!

Sleep Apnea

D

Bor>erline 'ersonality Disor>er

2< The iosocial mo>el states that or>erline personality >isor>er is a result o= a genetically >etermine> emotional sensitivity comine> ith a socially invali>ating rearing environment< True False

7< %hich skills mo>ule is not a part o= the stan>ar> DBT skills training mo>ulesP A

Interpersonal EMectiveness Skills

B

%ill 'oer Skills

!

!ore *in>=ulness Skills

D

Emotion Regulation Skills

E

Distress Tolerance Skills

3< DBT stan>s =or Dialectical Behavior Therapy True False 9< Emotion *in>  Logic *in>  UUUUUUUUUUUUUUUUUUUUUUUUUUUUUU< A

Best *in>

B

Intelligent *in>

!

Bor>erline *in> /3

D

%ise *in>

&< *arsha Linehan originally create> DBT to treat UUUUUUUUUUUUUUU< A

Suici>al ehavior

B

Bor>erline personality >isor>er

!

Eating >isor>ers

D

Depression

(< An invali>ating environment means that its the parents =ault hen a person >evelops or>erline personality >isor>er< True False ,< The rst skills training mo>ule taught is UUUUUUUUUUUUUUUUUU< A

Interpersonal EMectiveness Skills

B

Emotion Regulation Skills

!

Distress Tolerance Skills

D

!ore *in>=ulness Skills

-< The name o= the clinical manual y *arsha Linehan that outlines DBT is !ognitive:Behavioral Treatment o= Bor>erline 'ersonality Disor>er< True False

/4< %hich o= the =olloing is not a =eature o= or>erline personality >isor>er A

Emotion >ysregulation

B

!haotic interpersonal relationships

!

Sel=:inurious ehavior

D

*anipulative ehavior

/9

DBT Diar( Card $

/&

ame8

Happy 0-10

)o many >ays >i> you ll in your car>P 0-7

Date8 Ange Sham Sad Fear Guilt r e 0-10 0-10 0-10 0-10 0-10

Target Problem Behavior

U or A S%ill&uln otes8 UUrge "nten#i e## AA!tio 'ating ty n 0-$ 0-$

"un

Mon

#ues

Wed #hur s 9ri

"at

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate 3Stron 9Intense

Rate #rges 4:9

Skill=ulness Rating8

4 Di>nQt think aout using skills #rge to Huit Skills Training / Thought aout skills; >i>nQt ant to use #rge to Huit In>ivi>ual them Therapy 2  Though aoutante> to use skills ut >i>nQt "ther #rges8 7  #se> skills; ut they >i>nQt help 3  #se> skills . they ere help=ul 9  Di> not nee> skills; ut practice> them

Week $ DBT Skills Tracking Table Date8

Sun>ay *on>ay Tues>ay

%e>nes>a Thurs>a y

Fri>ay Satur>a

7oticed when % was in Wise Mind 7oticed when % was not in Wise Mind 7oticed when % was in $motion Mind 7oticed when % was in :ogica! Mind #emerature %ntense .h*sica! e0ertion .aced ;reathing

Setting Personal 6oals 3 Maintaining Motivation Be=ore e get into the core o= skills training; it is ise to egin y guring out hat your personal goals are in learning DBT skills< In other or>s; hat is it that you hope to achieve ith the skills you learnP +our goals are uniHue to you an> >eci>e> y you< *ost importantly; make sure that you set your goals accor>ing to hat you ant an> nee> not hat others say you shoul> ant an> nee>< For those ho are in a stan>ar> DBT program; personal goals ten> /(

to relate to prolem ehaviors< I= you are not sure ho to gure out your personal goals; DBT therapists ten> to use the =olloing hierarchy to target ehaviors in session accor>ing to their severity< +ou can use it to help you i>enti=y ehaviors you may ish to ork on hile you are in DBT skills training< DBT Be'avioral Targets #ierarc'( /< Behaviors that are li=e threatening or harm=ul 2< Behaviors that may inter=ere ith or >estroy therapy 7< Behaviors that aMect Huality o= li=e

Brainstorming Be'aviors I Want to C'ange 1

:ie #hreatening or
2 #hera* %nterering ;eha'iors

( ;eha'iors 5ecting Qua!it* o :ie

/,

SM.+T 6oals

*IT.,S Skills

S/eci7c Meaningful .c'ievable +ecordable

*alidate Self Imagine Take Small Ste/s .//laud :ourself ,ig'ten t'e ,oad

Timeline8based

Sweeten t'e Pot

SP)CI9IC : Smart goals are more specic than general< An eample o= a general goal is getting a o< To make this general goal more specic you might a>> hat o ant to get an>; perhaps; >escrie hat you nee> to get a o<

*alidate self V Acknole>ge the; 5I >onQt ant to UUUUUU;6 I>enti=y Emotional vulnerailities< IM.6I1) : Imagine you success=ully >oing each step toar> completing a goal or task as i= it ere a movie<

M).1I1690, : Smart goals have >eep personal meaning to enhance motivation an> persistence<

T.;) SM.,, ST)PS : Break >on a goal or task into clearly >etaile> steps

.C#)I*).B,) : Smart goals mean you have the means to achieve them<

.PP,.0D :O0+S),9 : Acknole>ge achievements hen completing steps success=ully toar> a >iOcult task or a goal

+)CO+D.B,) : Smart goals have recor>ale >ata or other i>entiale means to track progress<

,I6#T)1 T#) ,O.D : *anage overhelming tasks y taking small steps over time rather than procrastinating or trying to >o everything all at once<

TIM),I1) B.S)D : Smart goals have a clear timeline =or achievement<

SW))T)1 T#) POT : !reate motivation to ork on goals or complete un>esirale tasks y /-

coming up ith ays to rear> you along the ay<

24

SM.+T 6oal *IT.,S Works'eet 7ame

Date

%7"#R-C#%<7" Fill in the following worksheet to help you figure out a SMART Goal to work on while in DBT Skills Training. f you need help! use the pre"ious handout as a referen#e !y %!A"T +oal % eciic What is the spe#ifi# goal that  a$ going to work on%

!eaningu! &ow is $y goal $eaningful to $e%

Achie'a+!e Do  ha"e the skills and $eans to a#hie"e $y goal%

" ecorda+!e &ow #an  re#ord $y progress%

Time!ine8;ased What is $y ti$eline for a#hie"ing $y goal%

!y )ITA(% to %uccess )a!idate se! What $ight  not want to do to work on $y goal%

Imagine i$agine and then des#ri'e a#hie"ing your goal step 'y step

Take "ma!! "tes Break down your goal into at least three steps ( list the$.

A !aud 4ourse! &ow #an you a#knowledge your gains toward your goal%

(ighten 4our :oad &ow #an you lighten your load while working on your goal%

%weeten the .ot &ow and when #an you reward yourself to i$pro"e $oti"ation%

2/

DBT < ,evels of *alidation #andout Level / $ali>ate y >emonstrating Interest8 •

Listen to and observe what you and others are saying, feeling and doing in an unbiased manner with complete awareness.

•

Resist urges to interrupt others while they are speaking.

•

Make eye contact.

•

Ask questions that show you want to understand what you are hearing.

•

Be genuine and non-judgmental. Remember important information.

Level 2 $ali>ate y 'araphrasing •

Accurately reflect feelings, thoughts, assumptions, and behaviors.

•

Communicate understanding by restating information so that it is more coherent while keeping with the essence of the original conveyance. Be mindful not to be a “parrot” or repeat the shared information word for word

Level 7 $ali>ate y *in> Rea>ing8 •

Articulate thoughts, emotions, and/or behavior patterns not directly expressed.

•

Verify the facts of a situation and intuitively reflect them in terms of how they relate to the difficulty of the situation.

Level 3 $ali>ate Base> on )istory8 •

•

Recognize that every outcome has a cause and that for all responses there is a chain of events leading up to it. This is the opposite of minimizing problems and oversimplifying the ease of solutions, assuming that lack of will power is the cause of emotional suffering rather than a complex result of biologically based sensitivity combined with an intolerant environment

Level 9 $ali>ate Base> on !urrent Situation8 •

Articulate the ways in which a response is reasonable given the current situation.

22

•

•

Acknowledge the value in the other person’s intuition regarding the matter Describe how the response makes sense in that it is effective for short-term gains.

Level & $ali>ate y Demonstrating Ra>ical Genuineness8 •

Act directly, ordinarily, and as if you are talking directly to an equal.

•

Do not treat the other person as fragile, incompetent or like a child.

•

Convey credibility through a natural flow of communication.

•

peak in terms and language the other can sufficiently understand

•

!se a warm communication style that shows interest, sincerity " respect.

27

DBT < ,evels of *alidation Works'eet %7"#R-C#%<7" #he item in /uotes ater each num+er is an e0am!e o an in'a!idating statement #he second statement rerames in'a!idation into a 'a!idating statement 4our task is to igure out which o the si08'a!idation !e'e!s each ' a!idating resonse reresents 9ina!!*, i!! in *our answer in the !et co!umn #he irst answer is i!!ed in to get *ou started %n items )811, *ou wi!! additiona!!* i!! in *our own 'a!idating resonse as we!! as the !e'e! o 'a!idation it reresents (eel of )alidati on

Inalidating %tatement ,ollowed y a )alidating "esponse 1 4I don5t know why I hae to freak out eery time my oyfriend is a little late6



%t makes sense that *ou react so strong!* with ear when *our souse is !ate gi'en that, in the ast, *our caregi'ers wou!d !ea'e *ou sometimes or da*s without e0!anation 3 $o one eer listens to what I hae to say aout things76

When *ou ha'e something imortant to sa*, no one !istens 8

4There is no reason I should e so nerous6

#here is a!wa*s a reason *ou ee! the wa* *ou do whether *ou are aware o it or not 9

4I hate feeling sad76

%t sucks ee!ing sad and, unortunate!*, we must e0erience sadness in order to rocess the !oss o eo!e or things that are imortant to us :

4I5m sorry to ore you with all my drama6

% care and am interested in what is going on in *our !ie 11 4I need to think positie to get oer my prolems6 13 4I am too needy and dependent on others6 18 4I get upset oer stupid; little things6 19 4I should not feel this way6 1: 4ust a part of who I am6

Answer Ke : $8C 8T %8B >8T "8D <8. ?89 @8D A8T

23

Diar( Card Week 

29

1ame2

)o many >ays >i> ll car>P 07

Date2

Mood Hap Ang Sha Guil Sad Fear 0-10 py er me t

1otes2 Target Problem UUr U or A S$ill%ul Behavior ge "nten# ne## AA!t ity &ating ion

%unday

!onday

Tuesday =ednesd ay Thursday

,riday

%aturday

Indicate Target Behavior with U for Urge or A for Action. Rate the intensity level as:

+ate Interfering 0rges

Skillfulness +ating

&8"

4 Di>nQt think aout using skills / Thought aout skills; >i>nQt ant to use them 2  Though aoutante> to use skills ut >i>nQt 7  #se> skills; ut they >i>nQt help 3  #se> skills . they ere help=ul 9  Di> not nee> skills; ut practice> them

#rge to Huit Skills Training #rge to Huit In>ivi>ual "ther8

DBT Skills Training Tracking Tale Skill Practiced

Sunda( Monda(

Tuesda Wednes T'ursd Saturda 9rida( ( da( a( (

%orke> on S*ART Goal $ali>ate Imagine Take Small Steps Achievale Lighten +our Loa> Seeten the 'ot & Levels o= $ali>ation

2&

Core Mindfulness Skills Mindfulness is a quality of attention & awareness to the present. Watch the DBT Peer Connections Mindfulness skills training video on YouTube at http://youtu.be/J3pnmOucl_4

=hat %kills What to do to 'e $indful

&ow %kills &ow to 'e $indful

<+ser'e

7on8udgmenta!!*

Descri+e

.articiate

$ecti'e!* W#.T Skills

=hat %kills Are What to do to 'e $indful

<+ser'e

)'ser"ing 'rings you into the present

Descri+e Des#ri'ing is putting words to what you noti#e .articiate *arti#ipating is 'eing present fully in whate"er a#ti"ity you are engaging in.

"serve Observing brings you into the present

"tes to o+ser'ing •

•

9ocus on o+ser'ing one thing at a time 7otice the e0erience o o+ser'ing without descri+ing it

•

4ou can o+ser'e things inside o *ourse!

•

4ou can o+ser'e things outside *ourse!

2(

"serve )'ser"ing 'rings you into the present When a thought comes a!ong •

>ust notice it, then

•

Return *our attention to o+ser'ing

<+ser'ing inside •

"te +ack and watch *our mind

•

"ee % a thought comes in

•

7otice it

Descrie Des#ri'ing is putting words to what you noti#e •

4ou can descri+e things outside o *ourse!

•

4ou can descri+e things inside o *ourse!

•

4ou can descri+e thoughts too #he trick is to ut them into categories !ike

o

Worr* thoughts

o

.!anning thoughts

o

Critica! thoughts

?e* oints to remem+er when using descri+e •

Make sure *ou know the dierence +etween a thought and a act

•

Descri+e on!* what *ou o+ser'e 2,

•

Do not add to or su+tract rom what *ou see

•

Do not make interretations !ike descri+ing urrowed +rows, ursed !is as anger 'articipate

Participating is being present fully in whatever activity you are engaging in •

#hrow *ourse! into an acti'it*

•

;ecome one with the acti'it*

•

:ose se!8consciousness in an acti'it*

2-

#OW Skills

How ski!!s reer to

How "ki!!s "et

How to <+ser'e How to Descri+e How to .articiate

7on8udgmenta!!*
One8mindfull(

Means doing only )+, thing at a ti$e •

<+ser'e one8mindu!!*

•

Descri+e one8mindu!!*

•

.articiate one8mindu!!*

What intereres with one8mindu!!*@ •

•

7ot !iking the current moment *ou are in When the ast and the uture get in the wa*

#hree reasons to use one8mindu!!* 1 More eicient 2 5!!ows *ou to !i'e !ie to the u!!est ( Reduces suering

1on8udgmentall(

-udging is o'ser"ing a fa#t and then adding an e"aluation of good or 'ad to it. ?now the distinction +etween •

<+ser'ing and >-DA%7A 74

•

<+ser'ing and D$"CR%;%7A

>-DA%7A Mar* said something not true on urose and she is +ad or !*ing D$"CR%;%7A Mar* said something not true on urose & there were conse/uences or !*ing

7/

>udging is a shorthand wa* to descri+e conse/uences •

7$A5#%V$ = B+adB

•

.<"%#%V$ = BgoodB

>udging short hand sometimes conuses the dierence +etween8 •

>udging conse/uences as good or +ad

•

>udging ersons as good or +ad

Prolems with >udgments •

>udgments make it hard to react to the rea! wor!d

•

>udgments cause unending ro+!em emotions

"tes or reducing udgments 1 %s it a riorit* to reduce udging@ Do or do % not want to reduce udging@ 2 7otice udgments thoughts, actions, 'oice tone ( Monitor udgments +* counting them Remem+er do not udge *our udgingE F Re!ace udgments with conse/uences & know the dierence +etween udgments & acts

)Eectivel( ,ffe#ti"ely $eans doing what works "tes to +eing eecti'e G ask *ourse! 1 What are m* goa!s@ 2 What do % need to do to reach them@ 72

What gets in the wa* o +eing eecti'e@ 1 Wanting to +e right 2 7ot wanting to make the eort ( 7ot ocusing on *our most imortant goa!s

77

Mindfulness2 . Dail( Practice To uil> mastery in min>=ulness; one egins y trying as many kin>s o= min>=ulness tasks as it takes to n> one that orks =or you< %hen you n> one or a =e skills that speak to your ise min>; you ant to start incorporating your tasks into >aily practice< A common min>=ulness task that many peers use in their >aily practice is oserving the reath min>=ully< This is a goo> skill to start ith ecause it can e >one anyhere an> it orks on the nervous system to encourage calming an>or relaation< 6etting Started wit' Mindfulness Tasks To help you get starte>; you ill rst rea> some eamples o= min>=ulness per skill an> then you ill either select one o= the eamples or come up ith your on tasks to complete the =olloing orksheet< Observe Tasks Describe Task Partici/ate Task F One8mindfull( Task 1on8Gudgmentall( Task )Eectivel( Task

73

Mindfulness Skills Works'eet I1ST0CTIO1S2 Buil> yoursel= a ise:min>e> task list =or practicing min>=ulness< Descrie at least one task =or each o= the core min>=ulness skills< Fill in your tasks elo; accor>ingly< Then >o your task< Finally; come ack to your orksheet an> note any pleasant or unpleasant emotions; thoughts; or environmental inuences that you notice> hile you practice> your min>=ulness skills< I= the task you chose >i> not ork =or you; think o= a >iMerent task =or that skill; an> keep trying until you n> one that orks =or youeally >o at least one purpose=ul practice a >ay<

!indfulness %kill

? of times Practiced This =eek

*escrie !indfulness Task

<+ser'e #ask

Descri+e #ask

.articiate #ask

7on8udgmenta!!* #ask

$ecti'e!* #ask

79

DBT Diar( Card % ame8

W o= Days >i> you lle> car> 0-'

Date8

(ood Hap Ang Sha Sad Fear Guilt 0-10 py er me


UUrg otes8 U or A S%ill&uln e "nten#it e## AA!ti 'ating y on

"unda*

Monda*

#uesda* Wednesda * #hursda*

9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal

Skill=ulness Rating

Inter=ering #rges 4:9

4 Di>nQt think aout using skills / Thought aout skills; >i>nQt ant to use them 2  Though aoutante> to use skills ut >i>nQt 7  #se> skills; ut they >i>nQt help 3  #se> skills . they ere help=ul

#rge to Huit Skills Training #rge to Huit In>ivi>ual Therapy "ther8

D;# "ki!!s #racking #a+!e 9  Di> not nee> skills; ut practice> them Starting Date8

Sun>ay

Tues>ay %e>nes>a Thurs>ay

"serve Descrie 'articipate "ne:min>=ully on:u>gmentally EMectively "ther8 "ther8

7&

Fri>ay

Satur>ay

+ealit( .cce/tance Skills Watch the DBT Peer Connections Reality Acceptance skills training video on YouTube at http://youtu.be/LQmo3khTgRY =hen are "eality Acceptance %kills useful@ When ainu! e'ents haen and *ou cannot change them, so!'e them, or make them go awa*

+adical .cce/tance "adical Acceptance is accepting that 1 Rea!it* is what it is 2 $'er*thing has a cause ( :ie can +e worth !i'ing e'en when there is ain

"ememer

X .ain  7on85ccetance = "uering X %t is eas* to accet things *ou !ike X %t is hard to accet things *ou hate, disaro'e o , or that cause *ou a !ot o ain X #he higher the ain, the harder the accetance X % *ou want things to change, accet them, then change them X Rea!it* is a!wa*s changing and i *ou want to in!uence how it changes, *ou must irst accet it

Turn t'e Mind =hat is Turning the !ind@ %t is !ike wa!king down a road and coming to a ork where one road is acceting and one road is reecting and choosing to turn toward the acceting road o'er and o'er again

%teps to Turning the !ind 7otice anger, +itterness, anno*ance, a!!ing into the sea o IWh* me@J & when *ou are •

$scaing rea!it*

•

;!ocking things out Hiding how *ou ee!

•

2 Make an inner commitment to turn *our mind toward accetance 7(

( .ractice turning *our mind toward accetance o'er and o'er again

7,

Willingness =illingness is 

X 5!!owing the wor!d to +e as it is X 5greeing to articiate in the wor!d as it is K 5cti'e!* articiating in rea!it* K What *ou need to o'ercome a threat

Willfulness =illfulness is

X "a*ing 7<, 7<, 7< K Den*ing K .ushing 5wa* K 5'oiding

%teps to Turning =illfulness to =illingness

1 5sk *ourse!, a L IWhat is the threat@J + L I What is the catastrohe@J 2 7otice and o+ser'e wi!!u!ness ( Radica!!* accet the wi!!u!ness F #urn *our mind towards wi!!ingness, accetance, and articiating in rea!it* ust as it is  When it +ecomes diicu!t to Turn The Mind , adot a wi!!ing osture oen arms & a!ms, ha! smi!eE

6etting started wit' +ealit( .cce/tance Skills • •

9ind sma!! things to *ra#ti#e A##epting irst Write *ourse! a note that sa*s Turn the Mind , hang it somewhere, & ractice e'er* time *ou !ook at it 7-

7otice and o+ser'e Willfulness .ractice Willingness +* articiating in rea!it* • 5dot a Willing *osture oen hands, arms, ha!8smi!eE • Remem+er A##eptan#e is Diffi#ult and re/uires much time & ractice to +e eecti'e •

•

34

+adical .cce/tance Radi c alac cept anc ei saboutac cept i ngr eal i t yoral l owi ngt hewor l dt obej us tasi ti s . Thi si sas i mpl ei deabutav er yhar dc onc eptt oputi nt opr ac t i c e.Al t houghwemaywi s h t or adi c al l yac ceptourd eepes t ,mos tpai nf ulex per i enc es ,i ti smor ewi s et os t ar twi t h s mal lt as kst hatar eeas i erf ory out oac ceptl i k emi s si ngy ourf av or i t eTVs howl as tni ght asoppos edt oy ourt r aumat i cchi l dhood.Theeas i ert het as ki s ,t hemor el i k ey ouar et o h av es u c c es san dt h emo r es u c ce s sy o uh av e ,t h emor el i k e l yy ouar et ou set h es k i l l agai nandbui l dmas t er y . Abo v eal l ,r ememberwedono tac hi e v er ad i c al ac c ep t anc e;we pr ac t i c er adi al ac cept anc e.

Practice Ti/s for +adical .cce/tance /< 'ain  on:acceptance  SuMering 2< "serve i= you are Huestioning or ghting reality ith statements like; It is not =air< It shoul> not e this ay< 7< Remin> yoursel= that =or etter or orse reality is hat it is< 3< 'ractice accepting ith the hole sel=< ?*in>< o>y< an> spirit@< Be creative in n>ing ays to involve your hole sel=< #se accepting sel=: talk; ut also consi>er using relaation< *in>=ulness o= your reath< )al= smiling an> illing han>s hile thinking aout hat =eels unacceptale; prayer; going to a place that helps rings you to acceptance; or imagery< 9< 'ractice opposite action< List all the ehaviors you oul> >o i= you >i> accept the =acts< Then act as i= you have alrea>y accepte> the =acts< Engage in the ehaviors< That you oul> >o i= you really ha> accente>< &< !ope ahea> ith events that seem unacceptale< Imagine elieving hat you >o not ant to accept< Rehearse in your min> hat you oul> >o i= you accepte> hat seems unacceptale< (< Atten> to o>y sensations as you think aout hat you nee> to accept< ,< Allo >isappointment< Sa>ness< "r grie= to arise ithin you< -< Acknole>ge that li=e can e orth living even hen there is pain<<< /4< Do 'ros an> !ons yoursel= resisting practicing acceptance< 3/

i=

you n>

+adical .cce/tance Works'eet I NSTRUCTI ONS: Fort hi shomewor kt as k ,y ouar egoi ngt opi c ksomet hi ngt hatc aus esy oudi s t r es s .I tc an beas i t uat i on,ani dea,apl ac e,any t hi ngt hatex i s t st hatc aus esy oupai n.Tr yt opi c k s omet hi ngt hati sonl ow endofdi s t r es ssi nc ewewantt os t ar ts mal l .Forex ampl e,y ou mi ghtpr ac t i c eac cept i ngt hati t sac l oudydayort haty ouhav et owai ti nl i neatas t or e. T r yt op i c ks o me t h i ngt h aty o ua r el i k e l yt oh av es u c c es swi t h .Onc ey o uh av ec h os e n y o urac c ept anc et opi c ,ans werqu es t i on1andr e vi e wt her es toft heques t i onss oy o u k no w wh att op ayat t en t i o nt owh i l ee ng age di nt h ep r a c t i c e.Wh eny o uh av ec ompl e t e d y o ura cc ept anc et as k .( Ho wl ongy o upr ac t i c ei supt oy o u.Thenr ec or dy o ure x per i enc e us i ngt hewor k s hee tasy ourgui d e.

1 .Onas c al ef r o m0 1 00 ,wh ati smyl e v el o fa c c ep t a nc eBEFOREpr ac t i c i ng Ra di c a lAc c e pt an c e?

2 .Cr ea t eaRad i c al Ac c ep t a nc ema nt r at h aty o uc a ns a yt oy o ur s e l ft h ath el p sy o u t ur nt o war dac c ept anc e.Fore xampl e,y oumi ghts ay . “ Theonl ywa yt ol etgoof s uffer i ngi st oac c epts uffer i ng. ”or“ Idon’ tl i k ei t ,buti ti swhati ti s . ”or“ Pai n+ No na c c ep t a nc e=Su ffer i n g. ”

3.WhatPr obl em t hought scameupi fany?

4.Whatbodys ens at i onsdi dInot i c ewhi l epr ac t i c i ngr adi c al ac c ept anc e?

32

5.Whatemo t i onsdi dInot i c ewi t hi nmy s el fa sIpr ac t i c edRadi c al Ac c ept anc e?

6.I fy o uha v eahar dt i mepr ac t i c i ngRadi c al Ac c ep t anc e,whatdoy o ut hi nkgo ti n t h ewa y ?

A 7 .Onas c a l ef r o m0 1 00 ,wh a twa smyl e v e lo fa c c e p t a nc e FTER pr ac t i c i ng Ra di c a lAc c e pt an c e?

8 . Myde ep es tt h oug ht s ,f e el i n gs ,o ro t h erc omme nt sIwa ntt os h ar ea bo utt he homewor k.

37

+ealit( .cce/tance Skills 4ui5 1. The higher the pain a situation causes, the harder it is to radically accept the situation. a. True b. False 2. Once you accept something, you will always accept it from that day forward.

a< True < False 3. Practice _________________. Notice ________ a. %ill=ulness; illingness b. %illingness; ill=ulness c. %ill=ulness; ill=ulness d. %illingness; illingness . Pain ! non"acceptance # _____________ a. Distress b. SuMering c. Bor>erline personality >isor>er d. Ra>ical acceptance $. %adical acceptance and forgi&eness are the same thing a. True b. False 1. Turning the mind is li'e coming to a for' in the road where one side of the road is acceptance and the other is non"acceptance and choosing to turn your mind toward acceptance o&er and again.

c< True >< False 1. (hich of the following is not a reality acceptance s'ill)

a< %illingness 33

< Turn the *in> c< Ra>ical Forgiveness >< otice %ill=ulness *. (hen starting out with radical acceptance it is wise to start with _____________ a. The things you ant to accept the most b. Things that others ant you to accept c. Easier things to accept d. )ar>er things to accept

1. The __________________ the pain, the __________________ the acceptance. a. )igher; easier b. Loer; har>er c. Loer; higher d. )igher; har>er

1. +ou must first accept a problem before you can begin to sol&e it a. True b. False

Anser Key8 /:a 2: 7: 3: 9: &:c (:c ,:c -:> /4:a

39

Mindfulness to Willingness 3 Willfulness Works'eet Radica! accetance sounds eas*, +ut accetance in itse! is not a erect state #hereore, accetance is not a means to an end, +ut rather a ractice that we must continue throughout our !ie


%n the second set o +o0es, think o current situations where *ou wou!d !ike to work on wi!!ingness6wi!!u!ness Descri+e what *ou wi!! do to cu!ti'ate wi!!ingness and what things wi!! he! *ou notice wi!!u!ness

Current %ituation  =illingness %trategy

Current %ituation  =illfulness %ignals

3&

,oving ;indness Loving:kin>ness is a reality acceptance skill that e use to acknole>ge reality hile cultivating uncon>itional compassion< In practicing loving: kin>ness; e consciously an> intentionally sen> arm ishes to ourselves an>or others using a personal chant; script; or >ialogue that e say alou> or internally as e practice Huiet min>=ul reathing< 'racticing loving:kin>ness reHuires us to e in ise min>< As e =ocus on the target o= our ell ishes; e let go o u>gments; epectations; an> >esires< In the =olloing min>=ulness eercise; e ill start ith loving:kin>ness y sen>ing it to ourselves< "nce you ecome to =eel more com=ortale using the skill; you can a>> others to your loving kin>ness practice< The key is to start ith people that you elieve it ill e easy to sen> ell ishes to an> ork your ay up to those that it may e har>er to sen> ell ishes< Also; I= you n> it too >iOcult to start ith yoursel=; you may egin ith a pet; your chil>; or anyone else that your ise min> suggests< Be=ore you start; on a scale =rom /:/44; please rate your >istress level Pre/aring to Practice ,oving ;indness /< Get seate> in a com=ortale position ith your =eet plante> at on the oor 2< 'lace your right han> over your heart ith the palm open; presse> gently on your chest 7< Fin> a single place to =ocus your gaCe; usually looking =orar> an> slightly >onar> 3< Take a =e >eep; slo; stea>y reaths in an> out through your nose 9< Focus on your reath to ring you into ise min>< ,oving ;indness Scri/t "TE8 riting your on script is also an option an> encourage> i= you ant to personaliCe your loving kin>ness practice to e more meaning=ul to your on DBT path or your spiritualreligious orientation< 3(

ISTR#!TI"S Say the =olloing script alou> or to yoursel= Huietly as you reathe >eeply an> min>=ully =or 7:9 minutes or as long as your in> min> suggests (ay I be happy # (ay I be healthy # (ay I have peace (ay I be loved # (ay I )now )indness # (ay I love and be )ind to myself

A=ter you nish; on a scale =rom /:/44; please rate your >istress level

3,

Diar( Card Week > ame8


Date8

(ood Hap Ang Sha Sad Fear Guilt 0-10 py er me


UUrg otes8 U or A S%ill&uln e "nten#it e## AA!ti 'ating y on

"unda*

Monda*

#uesda* Wednesda * #hursda*

9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal

Skill=ulness Rating


4 Di>nQt think aout using skills / Thought aout skills; >i>nQt ant to use them 2  Though aoutante> to use skills ut >i>nQt 7  #se> skills; ut they >i>nQt help 3  #se> skills . they ere help=ul

#rge to Huit Skills Training #rge to Huit In>ivi>ual Therapy "ther8

9  Di> not nee> skills; ut practice> them

ISTR#!TI"S8 Fill in the name o= the month< Then eneath each eek>ay; ll in the >ate< Sun>ay *on>ay Tues>a %e>nes>a Thurs>a Fri>ay Satur>a y

Radica! 5cce tance #urn #he Mind .ractice Wi!!in ness 7otice Wi!!u!ness

3-

:o'in ?indness

94

Distress Tolerance Skills Overview Watch the DBT Peer Connections Distress Tolerance skills training video on YouTube at http://youtu.be/pkzpXrYXdKQ

;): POI1TS What is the function of distress tolerance skills?

To help you get through a crisis ithout making it orse<

W'at is a crisisH A situation causing intense emotionalphysical suMering that you cannot imme>iately  in the moment it occurs<

#ow do distress tolerance skills workH y teaching you eMective ays o= >istracting an> soothing yoursel= hen overhelme> ith emotionsthoughtsevents

#ow is distracting diEerent from avoidingH Distracting is a skill use> hen a prolem you cannot solve right no is causing you >istress< .voiding is attempting to hi>e or escape >istress cause> y a prolem you coul> solve i= you approache> it<

9/

STOP Skills

Stop hat you are >oing Take a step ack "serve the situation 'rocee> eMectively Introduction n >ialectical ehavior therapy ?DBT@ skills training; the ultimate goal is to learn an array o= use=ul skills an> apply them to prolems in or>er to gure out hat skills ork est =or you< Through this process; over time; you ill come to replace prolematic emotional responses ith more eMective ones; re>uce emotional suMering; an> hope=ully increase your capacity to eperience oy< )oever; hile the process o= skills training is a clearly gra>uate> process o= steps that procee>s =rom one mo>ule to the net smoothly; the real course o= change; hen it comes to automatic emotional responses; is >iOcult; ongoing; an> certainly not a straight line< First; e all have >iMerent styles o= learning< A>> to that the uniHue circumstances o= our environments; hich inclu>e varying =actors o= social support; stressors; an> our aility to control stressors; an> you can see hy uil>ing skills mastery is not so straight=orar><

+ationale The reality is that to change emotional responses reHuires >aily commitment to making steps toar> personal goals an> hen there are situations that cause you to step ack an>; perhaps; not use skills or act on urges to >o prolematic ehaviors; you get ack into ise min> an> commitment to your DBT path as Huick as possile so that you continue to make progress< This care=ul alancing act o= >etermination toar> change an> acceptance o= onesel= =or ehavioral slips is calle> >ialectical astinence< In practicing >ialectical astinence; ST"' skills are a use=ul set o= skills that aim to help you re>irect your attention an> action hen you n> you are ecoming emotionally >ysregulate> an>or have a slip in target ehavior<

#ow to .//l( STOP Skills To help you uil> a personaliCe> ST"' skills plan; rst you ant to i>enti=y =actors that you can recogniCe in the moment that signal to you that you are either getting close to or are outsi>e your in>o o= tolerance; hich is the point here you ecome so emotionally >ysregulate> you regress into past patterns o= prolematic responses< These =actors comine> >ene your s)ills brea) down point. I>enti=ying =actors ?o=ten calle> triggers@ can e actions; 92

o>y sensations; cognitions YthoughtsZ; events; an> =eelings; or &!"*+ ; =or short<

97

%T-P %kills %trategy =orksheet $ame/

*ate/

I$%T"#CTI-$%/ 9i!! in items 18( ater re'iewing the D;# "#<. ski!!s introduction, rationa!e, and the +rie summar* descri+ing how to a!* them #hen a!* *our "#<. ski!!s in a rea! situation during the week 7ote *our distress !e'e! on a sca!e rom 81 +eore and ater using the ski!!s :ast!*, descri+e how *ou roceeded eecti'e!*, and i *ou did not roceed eecti'e!*, descri+e what *ou did instead and what *ou think ma* ha'e got in the wa* o *ou a!*ing *our "#<. ski!!s strateg* eecti'e!*

Before

After

R5#$ D%"#R$"" 81

R5#$ D%"#R$"" 81

$! ,IST .BC)9 SI61.,S I1DIC.TI16 :O0 .+) .T O+ 1).+ D:SCO1T+O, .ctions; Bo>y sensations; Cognitions YthoughtsZ; )vents . 9eelings o= >yscontrol Signals ithin yoursel= an> environment that in>icate you are near or are at skills reak >on point<

! W#.T TO DO TO M.;) S0+) :O0 STOP W#.T :O0 .+) DOI16H et; >escrie ho you can act to take a step ack =rom the situation net time you notice you are eperiencing the AB!EF signals you liste><

3 =&AT CA$ '-# *- T- TA. A %TP BAC. ,"-! T& %IT#ATI-$

 =&AT ,ACT% -, T& )$T *I* '-# -B%") $-$#+!$TA(('@ 93

8 &-= *I* '-# P"-C* ,,CTI)(' -" =&AT +-T I$ T& =A'@

99

.CC)PTS Skills Act i vi t i es

Do at least one pleasant activity a >ay to help increase your likelihoo> o= eperiencing oy; an> to create an opposing =orce to unpleasant emotions<      

Go =or a alk !lean your house 'lay a vi>eo game Do gar>ening Listen to music %atch a movie



'lay Sports %rite a 'oem Rea> an enoyale ook !all or visit a =rien> Do your DBT homeork



Go in>o shopping

   

9&

Cont r i but i ng

Do $olunteer orkN make or >o something nice =or someone elseN give something to someone ithout epecting anything in return Compar i sons

!ompare your li=e to those less =ortunate than youN !ompare yoursel= no to a time hen you ere orse oMN %atchrea> aout others suMering< Opposi t eEmot i ons

Do something that prompts the opposite emotion you are =eeling< For eample; i= you are sa>; you might atch a =unny movie< Pushi ngaway

'ush the >istressing situation aay =or a hile< Imagine a all eteen the situation or putting your pain into a o an> up on a shel= out o= your sightmin>< Thought s

Distract yoursel= =rom the >istressing situation temporarily y counting the colors you see; shapes; people; trees; or anything

9(

.CC)PTS Skills Works'eet ame8

Date8

Therapist8

%n the o!!owing chart i!! in *our own 5CC$.#" tasks or each ski!! #hink a+out what ma* +e useu! to *ou in reducing *our distress when o'erwhe!med #hen during the week when *ou e0erience distress, note *our !e'e! o distress on a sca!e rom 81, a!* *our task and rate *our distress !e'e! again using the same sca!e Record *our distress !e'e!s to get an idea o how we!! each task worked % it did not work, kee tr*ing new tasks unti! *ou ind one that works or *ou

Acti'ities

Distress Before 81

Distress After 81

Contri+uting



Comarisons



motion oosites



Pushing awa*



Thoughts



%ensations



9,

IMP+O*) Skills #andout

Imager( Imagine a relaing scene; coping ell; hurt=ul emotions >raining out you like ater =rom a spout< The i>ea is to use your imagination to transport you to a place o= calmness<

Meaning Fin> or create meaning =rom your pain y =ocusing on ho hope can come =rom pain=ul situations<

Pra(er "pen your heart to a higher eing or poer hether it e the Great Spirit; Go>; Allah; Go>>ess; Tao; your %ise *in>; or hatever spiritual connection you may i>enti=y<

+elaation Try tensingrelaing your muscles one group at a timeN stretch min>=ullyN massage your neckN take a hot ath or cool shoer

One t'ing at a time Focus your entire attention on a single task; ringing your min> . o>y aay =rom multi:tasking to atten> to every >etail o= hatever process you are >oing

*acation atch your =avorite T$ shoN Go to the park . lounge in the grass an>or turn oM your phone =or a >ayN Go camping =or the eeken>N take a nap ith a so=t lanket

)ncouragement !heerlea> yoursel= ith statements like; 5I can get through this<6 5I am >oing the est I can<6 5This ill not last =orever<6 "ther8 9-

IMP+O*) Skills Works'eet ame8

Date8

Therapist8

%n the o!!owing chart i!! in %M.R
%mager*

Distress Before 8 1

Distress After 8 1

Meaning



.ra*er



Re!a0ation





Vacation



$ncouragement 8



&4

&/

Sel=:soothe ith the Senses %orksheet Sig't %atch the sun rise or setN got to a local art shoingN get your nails >oneN light a can>leN get a novelty light "ther8

Sound Listen to soothing music or nature soun>sN sing your =avorite songN play or learn to play an instrumentN >onloa> a min>=ulness ell app =or your smartphone "ther8

Taste suck on a piece o= har> can>yN che your =avorite avor o= gumN uy yoursel= a small gourmet treat< sip a cup o= hot chocolate or ice> mocha; sloly "ther8

Touc' 'et your >og or catN hug someoneN take a ule athN have a massage "ther8

Smell Light a scente> can>le; incense; ear your =avorite per=ume or cologne get some =resh oers =or home "ther8

&2

Make a Self8soot'e ;it #omework Fin> a small asket; purse; o; etc< an> ithin it place at least one soothing item per sense ?sight; soun>; Taste; Touch; Smell@< Keep it in a convenient place here you can Huickly get to it in a crisis<

!y %elfDsoothe .it Items

"ight "ound #aste #ouch "me!!

&7

Diar( Card Week "

ame8


Date8

Target otes8 U or A S%ill&ulne## (ood Hap UUrge Ang Sha Sad Fear Guilt Behavior "nten# er me 'ating 0-10 py AA!ti AA!tion on ity "unda* Monda* #uesda* Wednesda* #hursda* 9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate 3St 3Stro ron n 9Int 9Inten ense se

Skill=ulness Rating


4 Di>nQt think aout using skills

#rge to Huit Skills Training

/ Thought aout skills; >i>nQt ant to use them 2  Though aoutante> to use skills ut >i>nQt 7  #se> skills; ut they >i>nQt help 3  #se> skills . they ere help=ul

#rge to Huit In>ivi>ual Therapy "ther8


*BT %kills Tracking Tale Starting Date8

Sun>ay

*on>ay

&3

Tues>ay

%e>nes>ay

Thurs>ay

Fri>ay

Satur>ay

&9

)motion +egulation Skills Identif(ing ,abeling 3 9unctions of )motions Watch the DBT Peer Connections Introduction to Emotion Regulation skills training video on YouTube at http://youtu.be/RkP5dCowv90

M(t's about )motions #omework I1ST+0CTIO1S2 or each myth about emotions, thin' of and write in an opposing statement that challenges the myth. The idea is to build awareness to myths and new dialectical perspecti&es.

/ a =unction< 2 shoul> not pay attention attention to pain=ul pain=ul emotions emotions<< 7< #npleasant #npleasant emotions emotions come =rom =rom not thinki thinking ng positive< positive< 3 shoul> not =eel =eel the the ay ay I >o< 9< Emotionally Emotionally sensitiv sensitive e people people ust like like to cause >rama< >rama< &< 'ain=ul 'ain=ul emotions emotions come come =rom lack lack o= ill ill poer poer<< (< Emoti Emotion ons s are are >um >um<< ,< Epressing Epressing emotions emotions is is a sign o= eakness eakness<< -< There There is a right an> an> rong ay to =eel =eel in every every situation situation<< /4 =eel aout things etter than I >o< /2one etter than regulating emotions< /7
&&

/9 alays =ollo my heart< /&<<

&(

Diar( Card Week < 1ame2


Date2

Mood Hap Ang Fea Sha Guil Sad 0-10 py er r me t

Target Problem UUr 1otes2 U or A S$ill%ul Behavior ge "nten# ne## AA!t ity &ating ion

%unday

!onday


,riday

%aturday



Skillfulness +ating

&8"




Sunda(Monda(

Tuesda Wednes T'ursd Saturd 9rida( ( da( a( a(

&,

&-

C'eck t'e 9acts of )motional +es/onses Watch DBT Peer Connections Check the Facts Emotion Regulation skills training video on YouTube at http://youtu.be/_TbHNtKd2_Q The =olloing tale provi>es a list o= emotions an> =actors to help you >etermine hether an emotional response an>or its level o= intensity is appropriate an> ts the =acts oi= a prolematic situation<

!T": The Intensity and duration of an e#otion is $usti%ed &y:

)o likely it is that the epecte> outcomes ill occur )o great an>or important the outcomes are 9ear 7ts t'e facts w'en2 r  +our li=e or that o= someone you care aout is threatene> a e 9  +our health or that o= someone you care aout is

.nger 7ts t'e facts w'en2

r e g  An important goal is locke> n .  +ou or someone you care aout is attacke> or hurt

Disgust 7ts t'e facts w'en2 t  Something you are in contact ith coul> contaminate you s u g  Someo>y hom you >eeply >islike is touching you or s i D love> one

)nv( 7ts t'e facts w'en2

( v  Another person or group gets or has things you >ont n ) have that you ant or nee>

(4

!heck the Facts o= Emotional Responses ?continue>@ ( s u o l a e 

ealous( 7ts t'e facts w'en2  A relationship or thing in your li=e is very important an>

>esire> y you  An important relationship or thing in your li=e is in

>anger o= eing >amage> or lost  Someone is threatening to take a relationship or thing e v o ,

,ove 7ts t'e facts w'en2 •

•

•

s s e n d a S

e m a ' S

n o i t o m ) r e ' t O

%ho or hat is love> >oes things or has Hualities that you value or a>mire Loving the person; animal or oect enhances the Huality o= your li=e or o= those you care Loving the person; animal or oect increases your chances

Sadness 7ts t'e facts w'en2 •

•

+ou have lost something or someone irretrievaly Things are not the ay you ante> or epecte> an> hope> them to e<

S'ame 7ts t'e facts w'en2 •

+ou ill e reecte> y a person or group you care aout i= characteristics o= yoursel= or your ehavior are ma>e pulic

JJJJJJJJJJJJJJJJJJJ 7ts t'e facts w'en • • • •

(/

(2

C'eck t'e 9acts Works'eet ame8

Date8

Therapist8

Instructions8 Think o= a time in the past eek hen you ha> an emotional response that you >i> not ant< #se this eperience as your gui>e to ansering the =olloing Huestions; hich are a step:y:step gui>e =or helping you check the =acts accor>ing to DBT< To get the est eMect; ll out this orksheet hile you are in ise min>; especially i= you are ne to skills training<

$!

%hat is my S#DS level o= >istress right noP -ubjective %nits of istress -cale rates #

7<

%hat is the response to the emotion that I >o not think as eMective in the situationP

3< %hat is the prompting event that lea>s up to the unante> emotional responseP

9<

)o >oes or >oesnQt my emotional response or its intensity t the =acts o= the situationP -ee *motions That +it the +acts handout as a reference if needed0

&<

%hat are my interpretations; thoughts; assumptions; an> u>gments; i= any aout the situation; others; or meP

(<

%hat is the orst that coul> happen i= I oserve my emotion ithout u>gment; resistance; or acting upon the urges it may cause to arise in meP

,<

%hat is the orst that can happen i= I act on the emotional urges; u>ge mysel= or others or suppress my emotionP

(7

-<

%hat is my S#DS level o= >istress ?4:/44@ no a=ter checking the

(3

Diar( Card Week ? 1ame2


Date2

Mood Hap Ang Fea Sha Guil Sad 0-10 py er r me t

Target Problem UUr 1otes2 U or A S$ill%ul Behavior ge "nten# ne## AA!t ity &ating ion

%unday

!onday


,riday

%aturday



Skillfulness +ating

&8"




Sunda(Monda(

Tuesda Wednes T'ursd Saturd 9rida( ( da( a( a(

(9

(&

O//osite to )motion .ction Use o''osite action when your e#otion does not %t the facts Watch the DBT Peer Connections Opposite Action training video on YouTube at http://youtu.be/hmvDk-zUcMY

9ear is2 is2 r T'e O//osite .ction for 0nGusti7ed 9ear a e 9 Do hat you are a=rai> o= >oing over an> over again •

r T'e O//osite .ction for 0nGusti7ed .nger .nger is2 is2 e g n Gently A$"ID person you are angry ith ?rather than 5 •

t T'e O//osite .ction for 0nGusti7ed Disgust Disgust is2 is2 s u g s *"$E !L"SE< Eat; >rink; stan> near; or emrace hat you i D =oun> >isgusting< •

* ' n $

T'e O//osite .ction for 0nGusti7ed )nv( 0nGusti7ed )nv( is2 is2 • • •

Inhiit >estroying hat the other person has Do the "''"SITE o= envious action urges !"#T +"#R BLESSIGS

0nGusti7ed ealous( is2 is2 * T'e O//osite .ction for 0nGusti7ed ealous( s u o LET G" o= controlling others actions ! a S)ARE hat an> ho you have in your li=e e > • •

is2 e T'e O//osite .ction for 0nGusti7ed ,ove is2 ' o : A$"ID the person; animal or oect you love •

((

"pposite to Emotion Action Use o''osite action when your e#otion does not %t the facts Watch the DBT Peer Connections Opposite Action training video on YouTube at http://youtu.be/hmvDk-zUcMY

Sadness is2 is2 s T'e O//osite .ction for Sadness s e n Get A!TI$EN approach; >o not avoi>< d a Do things that make you FEEL !"*'ETET an> sel=: " con>ent< e T'e O//osite .ction for S'ame is2 m a h hen your ehavior does not violate your on moral values " • •

t T'e O//osite .ction for 6uilt is2 ! i u A %hen you 1I22 34T be reecte> i= =oun> out

(,

O//osite .ction #omework

7ame

Date

#heraist

I$%T"#CTI-$%/ 5ter re'iewing the oosite actions handout or emotions that do not it the acts think o a time in the ast ast week where an emotiona! emotiona! resonse or its intensit* intensit* did not it the acts o the situation Make sure to choose a situation that is a !ower !e'e! trigger 9or e0am!e it is +etter to start with something !ike *e!!ing at a customer ser'ice reresentati'e o'er the hone than *e!!ing at a souse or imortant !o'ed one 5ter *ou determine a situation, use it as a reerence to i!! out the worksheet

What is the emotion % am e0eriencing that does not it the acts or intensit* o the situation@

What action urges does the emotion cause within me@ e0am!e I5nger makes me want to *e!!JE

What cou!d % do seciica!!* to act oosite to m* emotion@ "ee handout or reerenceE

F



What What can can % do do to ra ract ctic icee usin using g oo oosi site te act actio ion n to m* m* emot emotio ion n this this wee week@ k@

5ter 5ter rac racti ticin cing g oos oosite ite action action this this week, week, did m* emot emotion ion go u, u, down down,, or sta* the same@ $motion %ncreased

)

$motion Decreased

$motion "ta*ed the "ame

Wh* Wh* do do % think think the the emo emoti tion on went went u, down down,, or or sta sta*e *ed d the the same same@@

(-

N

Did % do the oosite action a!! the wa*@ % not, what do % think got in the wa*@

,4

Working wit' Primar( 3 Secondar( )motions

7ame

Date

#heraist

The easiest ay to gure out hether you are eperiencing a primary or secon>ary emotion is see hether the emotion ts the =acts an> that it is appropriate in level o= intensity< I= your emotion ts the =acts it is usually a primary emotion; i= it >oes not t the =acts it is usually a secon>ary emotion< #se the =olloing ochart to help you gure out hat emotion regulation skills to use =or primary an> secon>ary emotions< %hat is the emotion I am eperiencingP UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU .S;

Does the emotion t the =acts an> is it appropriate in level o= intensityP

:)S

1O

'rimary Emotion

Secon>ary Emotion

Solutions Solutions

: Ra>ically Accet the Emotion : Act on Emotion; : *in>=ulness to !urrent Emotion : Accept !onseHuences Grace=ully

: : : :

Ra>ically Accet the Emotion !hange Thoughts to Fit Facts "pposite Action 'rolem Solve

%as my emotion a primary ?ts =acts@ or a secon>ary emotion ?>oesnQt t the =acts@P

Primar( )motion

Secondar( )motion

%hat solution >i> I use =or my emotion an> hat as or as not help=ul aout itP ,/

Diar( Card Week @ 1ame2

)o many >ays >i> ll car>P 0-7

Date2

Mood Hap Sa Ang Fea Sha Guil 0-10 py d er r me t

Target Problem UUrg 1otes2 U or A S$ill%ul Behavior e "nten# ne## AA!ti ity &ating on

%unday

!onday

Tuesday =ednesday Thursday

,riday

%aturday



Skillfulness +ating

&8"




Sunda Monda Tuesda Wednes T'ursd Satur 9rida( ( ( ( da( a( da(

5cted oosite to 5nger 5cted oosite to 9ear 5cted oosite to "adness 5cted oosite to "hame 5cted oosite to Aui!t 5cted oosite to >ea!ous* 5cted oosite to 5nger

,7

Be'avior C'ain .nal(sis 3 Solutions 7ame

Date

#heraist

%7"#R-C#%<7" .ick a recent situation where *ou engaged in a ro+!ematic +eha'ior #hen read the /uestions and answer each item according!* Do a +eha'ior chain ana!*sis reera+!* right ater engagement #he ke* is to make sure that *our distress !e'e! is !ow enough to access wise mind and not re8engage

1 What ro+!ematic target +eha'ior am % ana!*zing@ 2 What was the intensit* !e'e! o the target +eha'ior on a sca!e rom 181@ ( How !ong did the target +eha'ior !ast@ 5ro0imate !ength o timeE F What romting e'ent in m* en'ironment set o the +eha'ior chain@

 What 'u!nera+i!it* actors were in m* en'ironment and me@

) What short8term re!ie did % get rom engaging in the target +eha'ior@

N What are the !ong8term conse/uences i % continue to do #arget ;eha'ior@

,3

Describing ,inks 3 6enerating Skills Solutions ISTR#!TI"S8 In the le=t column; enter the letter representing hat type o= link the ehavior is in the chain ?See elo<@ Then in the right column; >escrie the link ehavior in >etail< Belo each link >escription; rite in a skill you coul> use in place o= the prolematic ehavior< Repeat the process =or each link in the chain<

'ossile Types o= Behavior Links8

A  Action B  Bo>y sensation Event F  Feeling

#*e o :ink ABC,

D;# "ki!!


D;# "ki!!

#*e o :ink 5;C$9

.BC)9

!  !ognition YthoughtZ

E 

(ink 1 Descrition

Descri+e what ski!! *ou cou!d use instead o ro+!ematic !ink and how to a!* it




,9

D;# "ki!!

#*e o :ink 5;C$9

D;# "ki!!


D;# "ki!!


D;# "ki!!


D;# "ki!!



(ink  Descrition



Descri+e what ski!! *ou cou!d use instead o ro+!ematic !ink and how to a!* it

(ink E Descrition




(ink F Descrition

,&

D;# "ki!!


,(

Co/ing .'ead to Prevent 9uture Target Be'avior %7"#R-C#%<7" %n this section, strategies or re'enting uture target +eha'ior are generated #hen the* are a!ied the ne0t time an urge to engage in the +eha'ior arises Read each /uestion and then answer according!* using the inormation *ou recorded in *our ana!*sis 1 How can % reduce m* 'u!nera+i!it* actors in the uture@

2 Wa*s to re'ent the romting e'ent rom occurring again in the uture@

( What harm did the target +eha'ior cause@

F What are m* !ans to reair, correct and6or o'er8correct the harm caused@

 What are m* deeest thoughts and ee!ings % want to share a+out the e'ent@

,,

Diar( Card Week A ame8

)o many >ays >i> you ll in car>P 0-'

*onth+ear8

(oo Sad Angr Sham U or A "nten# d )oy 0- y Fear e * ity ay 0-10 10 0-10 0-10 0-10 Urge + ,evel1 Sun/

Target Behavior

S%ill&uln otes8 e##

0-$

(on / Tue# / ed / Thu r#/ Fri/ Sat/ ( Indicate Target Behavior with a U or A )Urge*Action+ Rate the intensity level as $=Minimal %=Moderate >=Stron "=Intense

4 Di>nQt think aout using skills

7  #se> skills; ut they >i>nQt help

/ Thought aout skills; >i>nQt ant

3  #se> skills . they ere help=ul

2  Though aoutante> to use skills ut >i>nQt


=Mild

Intensit( of 0rges &8 " #rge to Huit Skills #rge to Avoi> )omeork

ISTR#!TI"S8 Fill in the name o= the month< Then eneath each eek>ay; ll in the >ate< *ar an  in the o =or each >ay that you practice> a liste> skill< Sun>ay *on>a Tues>a %e>nes>a Thurs>a Fri>ay Satur>a y y y y y

.ro+!em "o!'ing ;eha'ior Chain 5na!*sis Aenerated "o!utions 5!ied "o!utions

,-

.BC P,).S) Skills 1atch the corresponding -)ills Training 5ideo on 6ouTube at the following 2in)

http8youtu<egoH%0L[",3 .BC Skills .ccumulate 'ositive Eperiences Buil> *astery Cope Ahea> o= Time =or Emotional Events

.ccumulate 'ositive Eperiences !uild a 2ife worth 2iving 3ow7

S'ort Term2 Do pleasant things that are possile no ,ong Term2 *ake !hanges in your li=e so positive events ill occur more o=ten< •

Increase pleasant events that cause pleasant emotions

•

Do one pleasant activity each >ay

•

Do things that make you =eel competent

•

!reate a >e=ense against helplessness an> hopelessness

!e mindful of pleasant experiences •

Focus attention on pleasant moments as they happen

•

Re=ocus attention hen prolematic thoughts arise

•

'articipate an> Engage Fully in the eperience

!e unmindful of worries •

Re=ocus thoughts o= the pleasant eperience en>ing

•

Re=ocus thoughts o= >eserving the eperience -4

•

Let go o= epectations aout the pleasant eperience

Buil> *astery •

Do at least one thing each >ay to uil> a sense o= accomplishment

•

'lan toar> success over =ailure

•

Do something >iOcult; ut achievale

•

Gra>ually increase the >iOculty over time

•

I= the rst task is too >iOcult; >o something easier

-/

Cope Ahea> o= Time =or Emotional Events •

I>enti=y a situation that is likely to cause overhelming emotions

•

Deci>e hat skills you ant to use in the situation

•

Imagine yoursel= coping eMectively in the situation right no

•

Rehearse coping eMectively y role playing ith therapist=rien>peer

•

Rehearse ith ne prolems that may come up

P,).S) Skills treat Physical

I,lness )at Balance> *eals .voi> >rug misuse Sleep Balance> )ercise Regularly

Treat 'hysical Illness • • • •

Take care o= you physical health See a >octor hen nee>e> Take me>ications accor>ingly Rememer that eing ill causes increase> emotional vulneraility

Eat alance> *eals • • • • •

Do not eat too much or too little Eat regularly an> min>=ully Stay aay =rom =oo>s that aMect emotionality Eat =oo> that have omega:7 =atty aci>s See a nutritionist i= necessary

Avoi> *oo> Altering Drugs • • •

Stay oM illicit >rugs Stay aay =rom alcohol use me>ications as or>ere> y prescrier

Sleep Balance> • •

Figure out ho much sleep you nee> a night to =eel reste> Sleep accor>ing to a consistent sche>ule\I= you have sleep >iOculties; plan a sleep sche>ule . stick to it

Eercise Regularly •

Eercise at least a little every >ay -2

• •

Try to uil> up to 24:74 minutes o= >aily eercise !onsult your >octor i= you have any special health consi>erations

-7

.BC P,).S) #omework / 'leasant Thing A Day %eekly %orksheet "unda* Monda* #uesda* Wednesda* #hursda* 9rida* "aturda*

/ Skill a Day to Buil> *astery %eekly %orksheet Monda* #uesda* Wednesda* #hursda* 9rida* "aturda* Monda*

*y 'LEASE Skills Daily Routine %orksheet #reat %!!ness

What #an  do daily to ensure  treat or pre"ent illness%

$at ;a!anced Mea!s

&ow $any Meals a day &ow $any sna#ks a will  ha"e% day will  ha"e%

7otes 5'oid Drugs

&ow will  $ake sure to a"oid drug $isuse% -3

What ti$es a day will  eat%

"!ee ;a!anced

What ti$e will  get up ea#h day%

$0ercise

What ti$e will  go to 'ed ,a#h Day%

&ow $any ti$es a week will  exer#ise! for how long! and doing what%

-9

Diar( Card Week $& 1ame2

#ow man( da(s did (ou 7ll in cardH 0-7

Date2

Mood Hap Ange Sha Sad Fear Guilt r me 0-10 py

Target Behavior

1otes2 UUr U or A S$ill%uln ge e## "nten AA!t #ity &ating ion

%unday

!onday

Tuesday =ednesda y Thursday

,riday

%aturday



Skillfulness +ating

&8"


#rge to Huit Therapy "ther8

Sun>ay *on>ay Tues>ay %e>nes>a Thurs>a Fri>ay Satur>a

Starting Date8

y

Accumulate 'ositive Ep< Sleep Balance> Buil> *astery

#rge to Huit Skills Training

Eercise

!ope Ahea> o= Time Treat 'hysical Illness Eat Balance> *eals Avoi> *isusing Drugs

-&

Inter/ersonal )Eectiveness Skills Interpersonal ffectieness %kills are a road ma or getting what *ou want through eecti'e communication and ma* +e +etter remem+ered +* the acron*ms *A"; !A$; +I); ,A%T

Re!ationshi $ecti'eness

<+ecti'e $ecti'eness

"e!8resect $ecti'eness

*escri+e

!indu!

+ent!e

,air

0ress Assert

A ear Conident $egotiate

Interested )a!idate as* manner

A o!og*8ree %tick to Va!ues Truthu!ness

" einorce

->ectie ffectieness G *A" !A$ "ki!!s *ou use to communicate non/udg$entally ( effe#ti"ely.

"elationship ffectieness G +I) "ki!!s *ou use to communicate resect to and or others

%elfDrespect ffectieness G ,A%T "ki!!s which *ou use to communicate resect or *ourse!

Describe Descrie the situation an> hat it is you ant or nee>< In using this skill; the key point to rememer is that you stick to only the =acts an> relay them non: u>gmentally

)/ress This skill re=ers to epressing your =eelings; thoughts; an> opinions aout the situation you ill have alrea>y >escrie>< In >oing this; it is ise to egin your statements in a manner that promotes active listening< This is achievale y using 5I6 statements as in 5I think6 or 5I =eel6 an> likeise avoi>ing statements that egin ith 5+ou6 or 5They6 hich imply lame -(

.ssert %hen communicating; it is essential to state eactly; clearly; an> as simply as possile hat it is you ant< For eample; instea> o= saying; 5The rule is not =air<6 Being assertive; one might say; 5To make the rule more =air; I suggest e >o thisUUUUUUUU<6 The key to assert is to state your reHuest plainly in a manner that is rm; ut respect=ul; an> non:u>gmental<

-,

+einforce Be prepare> to oMer reasons that support your point o= vie an>or reHuest< 'oint out the enets o= supporting your reHuest or point o= vie<

Mindful Be aare o= the potential emotional eMects o= the or>s you choose an> re: >irect =ocus hen >iscussions >ri=t aay =rom the topic at han> or take on a negative or personally >irecte> ton

.//ear Con7dent Sho con>ence in ho you communicate y using eye contact; speaking calmlyclearly; no>>ing aOrmatively hen others are >escriingepressingasserting their concerns; an> a>opting a illing posture ?sitting =orar> attentively; avoi>ing crossing arms; oMering open palms; smile<@ Appearing !on>ent encourages others to take your ants an>or nee>s more seriously<

1egotiate %hen there are competing points o= vie; proposals rarely n> acceptance ithout negotiating the >etails< Be illing to compromise< Be open; eile to a>ustments; an> even etter to come prepare> ith alternative solutions<

6entle Be respect=ul; kin>; an> courteous< Re=rain =rom accusatory language< For eample; rather than saying; 5+ou make me ma><6 Try; 5I am angry ith you<6 Also; another help=ul tip is to use and here you oul> normally use but ; especially hen criticiCing others< ote the >iMerence in tone in the =olloing eamples simply y changing one or>< 5I hear hat you are saying; but you nee> skills<6 5I hear hat you are saying and you nee> skills<6 I= you are going to vali>ate; use the or> and to link opposing perspectives< The goal is to treat oth your on an> the other personQs point o= vie as eHually important an> orthy o= >iscussion<

Interested Sho others interest y using eye contact; aOrmative no>>ing; an> not interrupting others hen they are speaking interest you< In replying; reect --

ack hat has een sai> an> i= your opinion is not epressly aske>; make sure others agree to hearing it e=ore oMering<

/44

*alidate Acknole>ge others =eelings an> opinions y reecting them ack non: u>gmentally< For eample; i= your =rien> says 5I hate i>iot >riversN they give me roa> rage]6 +ou oul> vali>ate their eperience y saying something likeN 5I can see that you are totally =rustrate> y other peopleQs >riving<6 The most important thing to rememer is that the goal in vali>ation is to acknole>ge hat is true or vali>< +ou >o nee> to necessarily agree; encourage; or approve particular =eelings<

)as( Manner 'resent a eile an> calm >emeanor hen the situation is tense< The more calm attentiveness you sho to others; the more likely they ill e com=ortale; receptive; an> illing to communicate ith you<

9air Be =air an> oective in your conclusions< I= you are going to criticiCe another; make sure your opinions arrive y atten>ing to alancing =acts rather than relying on personal pre=erence or emotions< Even i= you =eel strongly; resist the urge to regar> your =eelings or point o= vie as more important< !onsi>er other peopleQs nee>s an> ants in a>>ition to your on< Strive =or reciprocity in relationships; that is eHually giving an> receiving in relationships<

./olog( 9ree !onsi>er the =olloing statement< 5I am sorry; ut I have to >isagree ith you<6 I= you >escrie; epress; an> assert yoursel= appropriately an> accor>ing to your personal values; unnecessarily apologiCing simply ecause your point o= vie may not match that o= those ith hom you are communicating only serves to eaken the appearance o= sincerity hen a true apology is arrante><

Stick to :our *alues Kno hat your personal values; ethics; an> morals are an> >o not compromise them =or the sake o= avoi>ing conict or appeasing others< )oever; it is ise to keep an open min>; respect others values; an> hen it comes that you =eel the nee> to Huestion values; stick to your on as they are the only ones you are empoere> to manage<

/4/

Trut'fulness Stic Stick k to the the =act =acts s an> avoi avoi> > eagg agger erat atin ing; g; emel melli lish shin ing; g; or mak akin ing g u>gmental u>gmental statements< statements< Rather than saying; 5)e as totally ru>e<6 Re Restate state your assumptio assumption n =actually =actually<< 5)e 5)e ke kept pt interr interrupti upting ng others others hile hile they ere ere speaking<

/42

!indful/ ;e mindu! o en'ironmenta! 'u!nera+i!ities, *ours & others emotions Choose words careu!!*

Appear confident/ -se direct e*e contact head high, shou!ders +ack, arms uncrossed, a!ms oen

D).+ M.1 6I*) 9.ST

1egotiate2 Be egotiate2 Be illing to compromise i= there is unillingness to meet the specics o= your reHuest<

Works'eet 7ame

#heraist

Date

Describe the escribe the prolem8

)/ress your thoughts . =eelings aout the prolem8

.ssert; ssert; reHuest precisely hat you ant >one in or>er to  the prolem8

+einforce; einforce ; state the enets o= =ullling your reHuest

/47

Instructions2 %se %se this this wor) wor)sh shee eett to crea create te a plan plan for for e8ec e8ecti tive vely ly re9u re9ues esti ting ng someth something ing you want want or need need from from someon someone e where where the situa situatio tion n is uncer uncertai tain, n, emotionally arousing, and:or susceptible to con;ict.

*A" !A$ +I) ,A%T =orksheet HContinued +entle Descri+e wa*s *ou can communicate gent!*

Interested How can *ou show the other erson *ou are interested in what he6she sa*s@

'a !idate others emotions@ )alidate How can *ou 'a!idate

asy !anner Descri+e wa*s *ou can communicate with an eas* manner

,air/ What is air to *ou in this situation

Apology ,ree/ Descri+e what *our urge to ao!ogize might +e in this situation

/43

%tick to )alues/ What are *our 'a!ues in this situation@

Trut'ful2 %hat are the =acts you nee> to stick toP

/49

Diar( Card Week $$ ame8

)o many >ays >i> you ll car>P

Date8

Moo Happ Sham Sad Anger Fear Guilt d y e 0-10

Target Behavior UUrg U or A S%ill&ulne otes8 e ## "nten#it or 'ating y AA!ti 0-$ 0-$ on

%un

!on

Tues =ed Thurs

,ri

%at

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate 3Strong 9Intense

Skill=ulness Rating

Rate Inter=ering #rges 4: 9


#rge to Huit Skills Training #rge to Huit In>ivi>ual Therapy "ther #rges8

*BT %kills Tracking Tale ISTR#!TI"S8 Fill in the name o= the month< Then eneath each eek>ay; ll in the >ate< Fill in the rst letter =or the skill you practice> the o =or each >ay that you practice>< Eample D Sun>ay *on>ay Tues>ay

Starting Date8

%e>nes>ay Thurs>a

y

Descrie

Gentle

Epress Assert

Intereste> $ali>ate

Rein=orce

Easy *anner

*in>=ul Appear

Fair Apology Free /4&

Fri>ay Satur>ay

egotiate

Stick to $alues

Truth=ulness

/4(

Course +eview

/4,

Personal Peer )m/owerment Plan

/4-

Diar( Card Week $ ame8 (ood 0-10

Days you ll in the car>P 0-

Date8 Happ Ange Sham Sad Fear Guilt y r e

7

Target Behavior

UUrg U or A S%ill&ulne otes8 e "nten#it ## AA!tio y 'ating n

"unda* Monda* #uesda* Wednesda* #hursda* 9rida* "aturda* Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate 3Strong 9Intense

Rate Inter=ering #rges 4:9

Skill=ulness Rating 4 Di>nQt think aout using skills / Thought aout skills; >i>nQt ant to use them 2  Though aoutante> to use skills ut >i>nQt 7  #se> skills; ut they >i>nQt help 3  #se> skills . they ere help=ul 9  Di> not nee> skills; ut practice> them

Starting Date8

Sun>ay

*on>ay

//4

#rge to Huit Skills Trainin g #rge to Huit In>ivi>ual Therapy "ther8

Tues>ay

%e>nes>ay

Thurs>ay

Fri>ay

Satur>ay

///

DBT +esources DBT Smart P'one .//s +eviews http8ilove>ttapps

%ith the a>vent o= >igital in=ormation an> the orl>i>e e; the orl> o= psychotherapy an> society in general continues to look =or ne an> use=ul ays to incorporate >igital technologies into our every>ay lives< )ere the =ocus is specic to smart phone applications ?An>roi>; i"S(; etc<@ that aim to incorporate aspects o= >ialectical ehavior therapy ?DBT@< To >ate; a variety o= sai> applications can e >onloa>e> =ree an>or =or a mo>est price on the market ?either y e; iTunes; an>or Google 'lay@ an> ne ones are certainly on the ay< Each app presente> an> >iscusse> elo inclu>es >onloa> links; >eveloperQs summariCe> >escriptions veratim; an> my personal revie notes =olloing ?highlighte> in re>; ol> type@< This list means to provi>e a general overvie o= availale applications ith user notes an> is provi>e> purely =or your re=erence< #serQs are in=orme> to use the liste> applications at their on >iscretion an> are aare that the in=ormation provi>e> herein >oes not mean to replace therapy provi>e> y Hualie> mental health pro=essionals<

:Rachel Gill aka 'inki Tusca>erro DBT 'eer !onnections Foun>er

O/timism 9+)) KWindows Mac OSL iP'one Web "ptimism apps are sel=:tracking applications; >esigne> to help you increase your un>erstan>ing o= all the things that aMect your mental health< The apps act as a springoar> to >etect patterns in your health an> >evelop //2

strategies to proactively manage >epression; ipolar >isor>er; an> other mental health con>itions< ^ote8 This seems to e the most eile FREE so=tare =or managing a Dialectical Behavior Therapy ?DBT@ Diary !ar> an> skills tracking >igitally in that it provi>es synchroniCation across >evices an> the e; oMers graphical inter=ace =or vieing skillstarget ehaviors over time ?Fig< B@; provi>es a customiCale remin>er =unction; an> has clinician management option to allo =or collaoration an>or sharing reports ?Fig< !@ that may e sent to sel=; therapist; etc< accor>ing to user pre=erence< In my case; I have a eekly report sent at (pm the night e=ore my in>ivi>ual session to my therapist so she may have my >iary car> on han> e=ore I arrive =or t'era/(!

//7

OPTIMISM SO9TW.+) DBT DI.+: C.+D S)T0P I1ST+0CTIO1S2 #owever t'ere is a catc' to using t'is software as a diar( card! T'e interface must be manuall( con7gured wit' DBT s/eci7c data elements /rovided and arranged according to (our own /reference! T'is took me some time to 7gure out t'roug' trial and error! I contacted t'e develo/er about creating a function for savingNdistributing user tem/lates w'ic' ma( be included in future u/dates! T'is software is recommended for advanced com/uterNmobile a//lication users! #owever t'e good news is t'at all m( 'ard work is summed u/ in t'e screens'ot below! K9ig! . w'ic' will surel( cut (our set u/ time to a minimum! /

Go to 'tt/s2NNwww!o/timismonline!comNregister!/'/ an> register ith the esite< This allos you to ll in your >iary car>; receive remin>er notications; an> synchroniCe your >ata across >evices< For eample; I can ll in my car> on my computer; synchroniCe >ata; then open the app on my i'hone an> the >ata I entere> through my computer ill sho up on my i'honei'a>< ?An>roi> version is un>er >evelopment; accor>ing to the >eveloper<

2

Go to 'tt/2NNwww!7ndingo/timism!comN an> >onloa> the so=tare =or your computer ?%in>os; *ac "S@ to your >esktop or other relate> =ol>er<

7

"pen nely installe> so=tare =rom your programs start menu ?%in>os@ or applications =ol>er ?*ac@

3

In the main screen; click the !#ST"* utton in the !"RE DATA; then STA+ %ELL STRATEGIES; TRIGGERS; an> S+*'T"*S; respectively renaming each section an> customiCing >ata accor>ing to screenshot elo ?FIG#RE A@ =rom my so=tare conguration<

9

A=ter your so=tare is congure>; 'oint to title ar option FILE then click "LIE S+!<

&

!lick net to skip through the "LIE S+! intro>uction screen<

(

Login to the "ptimism server using your #SERA*E an> 'ASS%"RD that you create> hen registering ith the "ptimism So=tare esite< ?See

//3

step /@< ,

Select #'L"AD >ate =rom this so=tare to the online >ataase<

-

!lick !"TI#E< !ongratulations your DBT >iary car> is no set up an> rea>y =or tracking<

/4 "'TI"AL8 I= you have an i'honei'a>; go to 'tt/s2NNitunes!a//le!comNusNa//No/timismNid%"< >onloa> the app =rom iTunes an> sign in using the in=ormation you provi>e> =or registration< ?See step /@

FIG#RE A<

9I60+) B!

//9

9I60+) C!

//&

Breat'e+ela 9+)) KiP'one and .ndroid is a portale stress management tool; hich provi>es >etaile> in=ormation on the eMects o= stress on the o>y an> instructions an> practice eercises to help users learn the stress management skill calle> >iaphragmatic reathing< Breathing eercises have een >ocumente> to >ecrease the o>yQs _ght:or:ightQ ?stress@ response; an> help ith moo> stailiCation; anger control; an> aniety management< Breathe2Rela can e use> as a stan>:alone stress re>uction tool; or can e use> in tan>em ith clinical care >irecte> y a healthcare orker 1ote2 T'is is a must 'ave 9+)) mobile a// for an(one wit' a smart/'one w'o wants to 'el/ manage t'eir stress! .s a DBT related a// t'is software will 'el/ (ou build mindfulness to breat' b( /roviding (ou guided breat'ing instruction wit' visual gra/'ics and audio t'at (ou can customi5e to t'e second according to (our own in'aleNe'ale c(cle! T'is a// is 'ig'l( recommended for t'ose wit' aniet( Panic andNor PTSD related s(m/toms

//(

Bowls  .ut'entic Tibetan Singing Bowls 9+)) KiP'one Onl( Sirl your ngers sloly aroun> the e>ges o= the ols to create eauti=ul me>itative harmonic tones< Tap the ols; gongs; ells; an> tingsha cymals to a>> >epth an> variety to your music< E% Feature] Recor> an> save your masterpieces an> play them ack hile relaing or me>itating to ring peace to your min>; o>y an> soul< #se this app =or me>itation; music; relaation; an> personal ell:eing< 1ote2 In DBT grou/ skills training sessions t(/icall( begin wit' a mindfulness /ractice t'at ideall( utili5e a tibetan singing bowl t'at is ta//ed % times to signal t'e start of a mindfulness /ractice and $ time to signal t'e end of a mindfulness /ractice! T'is a//lication is great for t'ose w'o are leading mindfulness /ractices and are looking for a 9+)) digital alternative to /urc'asing an e/ensive Tibetan singing bowl! T'e audio is ecellent and nearl( indistinguis'able from t'e aut'entic bowl sound!

Mindfulness Bell 9+)) KiP'one and .ndroidrings perio>ically >uring the >ay; to give you the opportunity to hol> on =or a moment an> consi>er hat you are currently >oing; an> in hat state o= min> you are hile you are >oing it< Accor>ing to the 1en Bu>>hist teacher Thich hat )anh; this is an eMective means o= >eveloping min>=ulness<

//,

1ote T'is is a great 9+)) a//lication for building mindfulness! I like to set t'e timer to go oE randoml( and /eriodicall( t'roug' t'e da( to remind me to take a mindful moment to be /resent and breat'e dee/l(! T'e audio is 'ig' Qualit(!

DBT +eview 9+)) KiP'one onl(*anage your emotions an> improve your relationships ith DBT Revie; a personal:use DBT tool< This app as >esigne> as a learning a>unct =or people learning DBT or orking ith a DBT therapist< The =our categories o= skills are covere>< The app is ase> on *arsha LinehanQs 5!ognitive:Behavioral Treatment =or Bor>erline 'ersonality Disor>er6 ?/--7@< This app is not recommen>e> =or anyone un=amiliar ith DBT skills an> is not a sustitute =or therapy<

1ote2 T'is is a 9+)) DBT skills review a//lication for t'ose w'o are in t'e /rocess of skills training and are still building (our descri/tive knowledge of individual skills! .lt'oug' not as com/re'ensive as DBT Self8'el/ t'is is a decent 9+)) alternative!

DBT Diar( //-

R>!AA KiP'one and .ndroidhelps you keep a >iary o= your >aily urges; emotions an> skills use>< "ne o= the challenges o= keeping a >iary it is easy to =orget the eact >etails o= events hen you are lling out your >iary at night or e=ore a therapy session< The DBT Diary app solves this prolem y helping you keep a >etaile>; accurate >iary throughout the >ay; at the eact time o= each event; herever you are; y using your moile >evice<

1ote2 T'is is a DBT diar( card a//lication t'at oEers com/re'ensive data tracking! #owever t'e interface is not all t'at user friendl(! If (ou are willing to take t'e time to customi5e (our software I recommend using O/timism w'ic' is muc' more eible and 'as man( more o/tions for trackingNs'aringNmanaging target be'aviorsNDBT skills use!

DBT Diar( Card and Skills Coac' R>!AA KiP'one and .ndroid%hat DBT Diary !ar> has to oMer V Skills< L"TS o= them< It can e your Huick re=erence to your skills so that you >onQt have to carry aroun> your ook or in>er< Every skill is >escrie> in rea>ale language to help you un>erstan> them easily an> itQs all ust a Huick tap aay V Emotions< All the 5asic6 emotions are presente>; again ith >escriptions an> eplanations a Huick tap aay V Behaviors< The most troulesome are pre:loa>e> V !oaching< I= you kno you nee> to use a skill ut canQt think o= hich one or canQt rememer ho to choose; use the app< The coaching can e your virtual therapist< V !omplete customiCaility< Are you orking on something >iMerent or >o you have a >iMerent un>erstan>ing o= a particular skill or emotionP !hange it< ItQs that easy< +ou are not e>>e> to the ay itQs presente> in the app< ItQs all completely customiCale V -// skills< 'ut your emergency skills a tap aay< V Email<

/24

1ote2 I 'ave not /ersonall( used t'is a//lication so 'ave no additional info to oEer ot'er t'an t'e develo/ers /rovided descri/tion above! If (ou 'ave used t'is a//lication /lease s'are (our review wit' readers in t'e comments section!

DBT Self8'el/ R@!AA KiP'one and .ndroidis a tool that helps you manage overhelming emotions; reak >estructive impulsive ehaviors; navigate relationships an> cultivate min>=ulness< It contains skill >escriptions complete ith rationale an> practice tips that ill enale you to >evelop an> practice the nee>e> skills< The skills are ase> upon the principles an> skills taught in Dialectical Behavioral Therapy skill classes< The app can e use> in conunction ith psychotherapy or as a stan>alone sel=:help intervention as the skills can e implemente> into many situations an> settings<

1ote2 T'is is a com/re'ensive DBT skills review a//lication for t'ose w'o are in t'e /rocess of skills training and are still building (our descri/tive knowledge of individual skills!

DBT A$$ 9+)) K.ndroid onl(%ith this app; you ill Huickly get a ran>om >istress tolerance skill to >o< In a>>ition; =or each mo>ule; *in>=ulness; Emotional /2/

!ontrol; *anage relationships; an> Distress tolerance; are the skills represente> an> tutorials =or these< !ontains over /94 >iMerent suggestions on skill eercises< There is also the opportunity to create your on crisis list so you ill alays have it ith you< An optional mo>ule =or vali>ation has een a>>e> as >esire> y participants< The application is >esigne> in collaoration ith the participants in DBT treatment< Dt//2 can never replace pro=essional help; ut can serve as a tool =or DBT training<

1ote2 T'is a//lication /rovides reference to DBT skills! T'is a// oEers minimal information alt'oug' it could be made more useful wit' some added eEort from t'e develo/er! If (ou are looking for a DBT reference tool t'at is 9+)) and are not big on com/re'ensiveness t'is a// is for (ou!

DBT2 Inter/ersonal +elations'i/ Tools R>!AA KiP'one onl(Buil> a Der on the spot] All the help you nee> to instantly make one on the spot< Save the DEAR*AQs you make along ith priorities an> loa> them up henever you ant] V An Intensity !alculator to help you gure out eactly ho you shoul> ask =or hat you ant; or say no to others< V An Interpersonal *yth !hecklist< "ver time; keep track o= ho the myths you have in your hea> change] V A $ali>ation 0uiC< Do you kno ho to give vali>ation to yoursel= an> othersP #se this HuiC to get Huick =ee>ack on >iMerent scenarios so you learn ho to give vali>ation right aay] V Trouleshooting to help you hen you try to get hat you ant; ut still canQt] V Beauti=ul 'hotography<

1ote2 T'is is a good a// for t'ose of (ou teters wit' fast 7ngers and it would be a useful a// for /eo/le w'o are good at t(/ing if it were a deskto/ a//lication! T'e tool as afar as it references DBT skills does a good Gob of sta(iung in line wit' t'e skills learned in t'e Inter/ersonal )Eectiveness Skills module! T'e downside is t'at t'e interface lacks automation and reQuires mostl( tet entries /22

w'ic' can be tedious on mobile devices! If (ou want to kee/ (our inter/ersonal skills at arms reac' at all times t'oug' it is wort' t'e 7ve dollars!

DBT )motion +egulation Tools R?!AA KiP'one onl( %ith Eight DBT Tools8 #n>erstan> *y Emotion; Emotional *yth !hecklist8 Short Term )appiness Tool; Long Term )appiness Tool; "serve . Descrie Emotions; "pposite Action !alculator; $alues . 'riorities; *anage Etreme Emotions; Tips to use on the spot; an> a numer =or the ational Suici>e 'revention )otline<

1ote2 I 'ave not /ersonall( used t'is a//lication so 'ave no additional info to oEer ot'er t'an t'e develo/ers /rovided descri/tion above! If (ou 'ave used t'is a//lication /lease s'are (our review wit' readers in t'e comment section!

. Pilot Stud( of t'e DBT Coac'2 .n Interactive Mobile P'one .//lication for Individuals Wit' Borderline Personalit( Disorder and Substance 0se Disorder

S'ireen ,! +i5vi ,inda .! DimeE ulie Skutc' David Carroll Parsons Mars'a M! ,ine'an  Dialectical ehavior therapy ?DBT@ has receive> strong empirical support /27

an> is practice> i>ely as a treatment =or or>erline personality >isor>er ?B'D@ an> B'D ith comori> sustance use >isor>ers ?B'D:S#D@< Therapeutic success in DBT reHuires that in>ivi>uals generaliCe nely acHuire> skills to their natural environment< )oever; there have een only a limite> numer o= options availale to achieve this en>< The primary goal o= this research as to >evelop an> test the =easiility o= the DBT !oach; a so=tare application =or a smartphone; >esigne> specically to enhance generaliCation o= a specic DBT skill ?opposite action@ among in>ivi>uals ith B'D:S#D

1ote2 T'e link above refers readers to t'e scienti7c researc' literature for t'is a//lication! Currentl( t'e a// is not available for /ublic consum/tion! 9rom an academic /ers/ective it is wort' noting t'is is t'e onl( a//lication t'at I found t'at 'ad researc' literature informing its develo/ment! Develo/ers w'o do not necessaril( use sociologicall( informed measures to test t'e usefulness of t'eir DBT related /rograms create most all ot'er a//s on 6oogle Pla( and iTunes! #owever t'e 7eld of web8based /s(c'ot'era/( is e/anding Quickl( and as e/ansion continues 'o/efull( t'ere will be more /ressure to create evidence based a//s t'at are informed b( rigorousl( a//lied met'ods of scienti7c researc'

6lossar( .BC)9 Be'avior Be'avior C'ain .nal(sis Biosocial T'eor( Crisis Dialectical .bstinence Dialectical Be'avior T'era/( Dialectical T'inking Distress )motional Baseline )motional *ulnerabilit( /23

)motion .ction )motion D(sregulation )motion Mind )motion +egulation Invalidating )nvironment ,ogical Mind Mindfulness Paced Breat'ing Peer Su//ort Primar( )motions Prom/ting )vent +adical .cce/tance +eci/rocit( Secondar( )motions Sensations Skillful Means Skills Breakdown Point Target Be'avior S0DS *alidation Window of Tolerance Wise Mind

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.//endiI $eference materials utili 'ress< Linehan; *< ?/--7@< "ognitive#behavioral treatment of borderline personality disorder < e +ork8 Guil=or> 'ress< Linehan; *<; . Behavioral Tech; LL!< ?2447@< This one moment' -)ills for everyday mindfulness < Seattle; %A8 Behavioral Tech; LL!< Linehan; *<; . Behavioral Tech; LL!< ?2449@< +rom su8ering to freedom' Practicing reality acceptance < Seattle; %A8 Behavioral Tech; LL!< Linehan; *< ?/--7@< -)ills training manual for treating borderline personality disorder < e +ork8 Guil=or> 'ress< Linehan; *<; . Behavioral Tech; LL!< ?2449@< Getting through a crisis without ma)ing it worse' "risis survival s)ills < Seattle; %A8 Behavioral Tech< Linehan; *< *<; . Behavioral Tech; LL!< ?2449@< Putting your worries on a shelf' Progressive muscle and sensory awareness relaxation< Seattle; %A8 Behavioral Tech< Linehan; *<; Senson; [<; %altC; [< A<; DimeM; L< A<; . Behavioral Tech; LL!< ?244(@< 4pposite action' "hanging emotions you want to change< Seattle; %A8 Behavioral Tech<

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Dialectical Behavior Therapy Skills Training Workbook3

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