Week 8: Transdiagnostic and Dialectical Behaviour Therapy Flashcards
(27 cards)
Describe Transdiagnostic Therapy
Principal target of treatment is higher order temperament that underpins emotion disorder (rather than specific DSM diagnoses)
Designed to target a full range of emotional problems, considers the extensive comorbidity among emotional disorders
What is ‘Triple Vulnerability’ in transdiagnostic therapy?
A generalised biological vulnerability
A generalised psychological vulnerability
A specific psychological vulnerability (life stress)
What are the current CBT three broad principles of change for emotion disorders?
- Altering emotion
- Preventing avoidance of negative, emotional charged triggers - facilitating extinction of fear
- Reducing anxiety and distress over the experience of intense emotion
What DSM disorders are treated with CBT?
What DSM disorder is treated with DBT?
CBT - OCD, GAD, PTSD, SAD, insomnia, trauma, chronic pain, ED
DBT - BPD
What is Unified Protocol by David Barlow?
Form of CBT for people diagnosed with emotional disorders with an emotion focused approach and mindfulness.
Consists of 8 modules (5 core)
What emotion disorders are targeted by UP?
Anxiety, depressive, obsessive-compulsive & trauma related disorders.
Other disorders in which regulation of emotion plays a prominent role (somatic disorders, dissociative disorders, eating disorders, BPD)
What is module 1 of UP. Is it a core module?
Setting up treatment goals and motivation
Increase clients readiness and motivation for behaviour change. Foster a sense of self-efficacy.
Not a core module.
What is module 2 of UP. Is it a core module?
Psychoeducation - about the nature and function of emotions.
Primary emotions & secondary (social - judging or interpreting or own or others’ responses to our primary) emotions
Concept of negative reinforcement in avoidance.
Not a core module.
What is module 3 of UP. Is it a core module?
Emotion awareness training.
Promoting a more non-judgemental, present-focused approach to the experience of emotions - through mindfulness.
This is a core module.
What is module 4 of UP. Is it a core module?
Cognitive flexibility.
Help clients develop an understanding of how the interpret or appraise situations and how their appraisals influence patterns of emotional responding.
This is a core module.
What is module 5 of UP. Is it a core module? What are the three general categories of emotion avoidance strategies?
Identifying and countering emotion avoidance behaviours.
Three general categories of emotion avoidance strategies:
- Subtle behavioural avoidance (procrastination)
- Cognitive avoidance (distraction; worry)
- Safety signals (medication, lucky undies, prayer book)
This is a core module.
What is module 6 of UP. Is it a core module?
Awareness and tolerance of physical sensations; acceptance of emotions
Increase awareness of bodily sensations and how to confront those sensations if they are unpleasant
This is a core module
What is module 7 of UP. Is it a core module?
Situational and interoceptive emotion-focused exposure.
Interoceptive exposure - Practicing with stimuli to confront physical sensations and learn to control them
Situational exposure - a hierarchy of public speaking situations which are acted upon.
This is a core module.
What is module 8 of UP. Is it a core module?
Recognising accomplishments and relapse prevention.
This is not a core module.
What is probability overestimation and what is catastrophising?
Probability overestimation - the probability of a negative event happening
Catastrophizing - the consequences if the negative event does happen
What is a dialect and how does this relate to therapy?
Dialects is a method of argument or dialogue in which opposing views try to persuade each other.
Key dialect in CBT is between acceptance and change.
Who founded Dialectical Behaviour Therapy?
Marsha Linehan, born 1943
Explain the biosocial theory of borderline personality disorder
Biological and environmental combine.
Biological - emotional sensitivity, dysfunction of emotion regulation system from genetics, foetal development or early trauma
Environmental - an invalidating environment, potentially abusive
What are the three states of mind in BPD?
Reasonable mind - cool, rational, task focused
Wise mind - seeing the value in both reason and emotion, bringing left brain and right brain together.
Emotional mind - hot, mood dependent, emotion focused
What are the 9 DSM criteria for borderline personality disorder?
- frantic efforts to avoid real or imagined abandonment
- pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation
- Identity disturbance
- Impulsivity in at least two self-damaging areas
- Recurrent suicidal behaviour, gestures, threats
- Affective instability due to a marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger / difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms
What are the four stages of DBT treatment?
- Establish safety & behavioural control, skill development
- Increase appropriate experiencing of emotion
- Increase experience of normal happiness, improve relationships and self esteem
- Promotion of connectedness, achieve freedom (transcendence, mindfulness)
What role does mindfulness play in DBT?
It is the first skill taught, supports all other skills.
Teaches clients to observe and experience reality - develops a sense of connection to the universe
What is distress tolerance and the two distress tolerance skills?
The ability to tolerate and survive crises without making things worse.
Skills:
Crisis survival skills
Reality acceptance skills
What is the STOP skill in distress tolerance?
Stop
Take a step back
Observe
Proceed mindfully
