behavioural approaches

Question 1

Dialectical Behaviour Therapy (DBT)

Answer 1

• An evidence-based form of skills training
• Classified as a third wave of cognitive behavioural counselling along with acceptance and commitment therapy
• A mix between CBT and mindfulness

Question 2

intent of DBT

Answer 2

• improve client motivation to change
• enhance client capability
• generalize new behaviours
• structure the environment
• enhance the counsellor’s capabilities and motivation.

Question 3

DBT Activities

Answer 3

• brief mindfulness activity (observe thoughts for 15 min, lie back, release tension, focus on breathing, move awareness to body then thoughts, resist urge to label or judge your thoughts and let them pass by)
• self-soothe with senses
  (find pleasurable way to engage each of your 5 senses to help soothe negative emotions)
• emotional regulation (Identify an emotional reaction and describe the following: what was the prompting event? what was the interpretation? what was the emotion and intensity on a 0-100 scale? identify the function of the emotion: did it communicate something to influence their behaviour/ change their perception?)
• distress tolerance skill development (ACCEPTS)

Question 4

distress tolerance skill development (ACCEPTS)

Answer 4

ACTIVITIES engage in activities that require thought and concentration
CONTRIBUTING focus on someone or something other than themselves
COMPARISONS look at your situation and compare it to something worse
EMOTIONS do something that will create a competing emotion
PUSHING AWAY do away with negative thoughts by pushing them out of your mind
THOUGHTS when your emotions take over, try to focus on your thoughts
SENSATIONS find safe physical sensations to distract from intense negative emotions

Question 5

Mindfulness

Answer 5

• contemplative practices and philosophies relating to the development of a state of awareness characterized by an attentive and non-judgmental monitoring of moment-by-moment cognition, emotion, sensation, and perception, without intrusion from thoughts from the past or of the future
• consists of three core elements: intention, attention, and attitude

Question 6

Approaches that include Mindfulness

Answer 6

• Vipassana Meditation: two weeks, 10 hours per day in silence
• Mindfulness-Based Stress Reduction (MBSR): 8 weekly counsellor-led sessions; combines meditation with traditional cognitive therapy to prevent drug use reoccurrence
• Spiritual Self Schema Therapy: 8-12 week course; teaches meditation and mindfulness in context of comprehensive psychotherapy
• Acceptance and Commitment Therapy: incorporates mindfulness and acceptance, and commitment and behaviour change processes
• Mindfulness-Based Reoccurrence Prevention: self-compassion and acceptance; combines: mindfulness-based stress reduction, mindfulness-based cognitive therapy, and reoccurrence prevention
• Mindfulness-Oriented Recovery Enhancement: formal mindfulness meditation, debrief and group process, psychoeducation/didactic material, experiential exercise

Question 7

3 main training components of Community Reinforcement Approach (CRA)

Answer 7

• problem solving, communication skills, and refusal skills that emphasize assertiveness in uncomfortable and difficult settings
• supplemented with social and recreational counselling and job skills; mood monitoring and cognitive restructuring; relationship counselling

Question 8

Aversion Therapy

Answer 8

• least favoured form of behavioural therapy
• among the earliest approaches to treating addiction
• therapy induces a state of mind in which attention to an object is coupled with repugnance and a desire to turn away from it
• Goal to alter the individual’s attraction to a drug through counter- conditioning procedures
• Substance being misused is paired with any of a variety of unpleasant experiences
• Historically produced by drugs or electric shock; more recently through verbal conditioning
• If successful, the individual shows an automatic negative response when later exposed to the drug alone