Transcript DBT. Solution Focus. Recovery. CBT/Behaviourism.

DBT. Recovery.
CBT/Behaviourism.
Common Core Philosophy
Hope.
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Central to Recovery.
DBT: the life worth living.
CBT. Cognition and behaviour can change.
You can choose.
Working with strengths.
All look at the whole person, not the pathology.
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Recovery: regaining or developing valued
roles.
DBT. Encouraging mastery.
CBT. Focus on behaviour to increase –
what the person can do as opposed to
what they do wrong.
Normalisation.
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Recovery. Building a life outside the
services; employment focus.
DBT. Biopsychosocial model applies to
some degree to everyone.
CBT. We all have dysfunctional thinking
patterns and challenging behaviours
sometimes.
Common humanity, common
vulnerability.
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Recovery. Trainers devise their own WRAP plans.
Encouragement of employment of those who have
recovered in the services (experts by experience).
DBT. Therapists note own therapy intefering behaviours,
dialectical dilemmas and emotion mind.
CBT. Therapists monitor the effect of challenging
behaviour on their own arousal systems and thought
patterns, and sidestep reproducing the pattern or
responding from the raised state of arousal.
Collaboration.
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Recovery; service user sets the agenda.
DBT. Client must agree to work on
reducing self harm as a first priority, but
the life worth living is their own vision.
CBT – goals of therapy are arrived at
collaboratively.
Accepting reality
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Recovery. The concept of the turning point
means the point at which the individual
recognises whatever limitations are imposed by
their problems, and accepts what has happened
in the past – this makes taking ownership of
their future possible.
DBT. Acceptance is a core concept.
CBT. Individual needs to be prepared to take
responsibility for change.Work on changing
what’s changeable - no point challenging an
unchallengeable thought.
Self Monitoring
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Recovery: PIP.Identify wellness, and then
triggers and early warning signs for
relapse. Relapse is a normal part of
recovery.
DBT: Diary cards.Chain analysis.
CBT: Thought Diaries.
Response to Risk and challenge.
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Recovery. PIP – individual responsibility for
maintaining wellness and specifying what should
happen in case of breakdown.
DBT. Skills training, featuring mindfulness, to
master action urges.
CBT. Specifying behaviours to increase and
reinforcing them is the most efficient way to
decrease challenging behaviours.
Idea of Balance and Finding a
Middle Way
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Recovery. Balance between learning to live with
symptoms and a relapsing condition, and making the
most of life.
DBT. Always looking for the dialectic, and for the wisdom
in both poles while seeking a way through. There is no
one right way – the process carries on.
Behavioural approach to challenging behaviour –
balancing the obvious, behaviours to decrease with
emphasis on behaviours to increase.
CBT: you can choose the most helpful way to think about
things.
Unique features
Recovery. Service users, not
professionals, in charge.
 DBT. Skills training and mindfulness.
 CBT. Individual formulation of difficulties.
However – the similarities are more striking
and numerous than the differences.
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Common Core Philosophy.
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Hope
Working with strengths.
Normalisation.
Common humanity, common vulnerability.
Collaboration.
Accepting reality.
Idea of Balance and Finding a Middle Way.
Proactive, collaborative response to risk and
challenge.
Implications for staff role.
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Staff need to hold hope and vision for the individual even when they
cannot yet see it.
Staff need to concentrate their efforts on identifying and working
with the person’s strengths and interests.
Staff need to see the person as they might fit into society to help
them maximise their prospects. They need to listen to the person
and take seriously what they say.
Staff need to be aware of and manage their own emotional
reactions.
Staff need to develop their skill in working collaboratively.
Staff have a vital role in enabling the person to accept what has
happened and its consequences, and take responsibility for
continuing problems.
Staff must keep in mind the need to balance working with strengths
with realistic support with problems.
In managing risk, staff need to seek the full collaboration of the
service user.