House of DBT

Question 1

Basis rules

Answer 1

The stages are organised and curated to each client’s needs and goals. Many go from pre-treat to stage 1, some go through all.

2 years preferred over 1, as stage 2/3 feel like open wound

Stages can overlap and doesn’t have to go in chronological order.

Each stage has an overarching treatment goal w specific targets.

Question 2

Pre-treatment

Answer 2

Effective orientation, building trust, motivating for change and agenda setting.

Setting up DBT contract with key policies and agreements, plus commitments for both therapist and client.

One of the most important phases

Question 3

Stage I: Severe behavioural dyscontrol

Answer 3

Goal: Behavioural control

Target: improve behavioural control and increase skill use.

Session: Diary card, in order focus on SIB, TIB, QIB

Question 4

Stage II: Incompleteness

Answer 4

Goal: Emotional experiencing

Target: Addressing trauma, experiencing emotions

Session: Axis I treatment, CBT protocols or ACT.

Question 5

Stage III: Problems in living

Answer 5

Goal: Ordinary happiness and unhappiness

Target: Self-respect and individual problems living

Session: Solidifying and generalizing learned skills. Bolstering quality of life. More CBT and ACT skills and mindfulness

Question 6

Stage IV: Incompleteness

Answer 6

Goal: Capacity for sustained joy

Target: Expanding awareness, peak experiences

Session: Consider place in the world through self-actualization. Reflect on how to achieve greatest potential.

Question 7

Target behaviour and skills

Answer 7

SIB; self-harm. No treatment is effective when you’re dead.

TIB: Interfering, missing sessions/being late. Non-dialectical/punish

QIB: eg health crisis, SU, depression, PTSD

Skill acquisition: Replacing problematic/goal-interfering behaviour with: mindfulness, interpersonal effectiveness, emotion regulation and distress-tolerance