Ch 6 Structuring Treatment (Linehan, 1993)

Question 1

What are the stages of treatment?

what order do they come in?

Answer 1

• Pretreatment
• Stage 1: Attaining basic capacities
• Stage 2: Reducing Post-Traumatic Stress
• Stage 3: Increasing self-respect and achieving individual goals

They are presented this way for simplicity but they don’t unfold in a linear fashion and aspects of different stages can be relevant throughout therapy

Question 2

What is targeted in Stage 1: Attaining basic capacities

Answer 2

1. Life threatening behaviours
2. Therapy interfering behaviours
3. Quality of life interfering behaviours
4. Deficits in behavioural skills

Question 3

What is the goal of the pre treatment stage?

Answer 3

Orientation and commitement
goal 1: arrive at a mutual decision to work together (commitment)
goal 2: identify and modify dysfunctional beliefs about therapy, reframe therapy as a learning process.

Question 4

What is targeted in Stage 2: Reducing Post-Traumatic Stress

Answer 4

Begins when the target behaviours in stage 1 are under control and involves exposure to trauma-related cues (see page 171 for more nuanced description)

Question 5

What is targeted in Stage 3: Increasing self-respect and achieving individual goals

when does this stage occur?

Answer 5

Enhancing self respect through developing the ability to trust the self, validate ones own emotions, opinions, and actions, reducing self-hate and shame

Teaching the client independce but also that they can appropriately depend on others

Overlaps with first 2 stages

Question 6

How is self-respect increased?

Answer 6

Primarily through the relationship between the client and therapist and self-respect beahviours as they occur or fail to occur in this relationship