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Dialectic Behavior Therapy Essay

2829 words - 12 pages

Mid Term AssignmentManru Vivian ZhangNew York UniversitySilver School of Social WorkSubmitted to:Professor Besa Bauta, Ph.D.Social Work Practice IIIOct, 22, 2014Theoretical Underpinnings of Dialectical Behavior TherapyDialectical Behavior Therapy (DBT) has demonstrated considerable efficacy in clinical social work practice, especially in the treatment of borderline personality disorder (BPD) (Hoffman, et al., 2005; Rakfeldt, 2005; Panos, et al., 2014; Schulz, & Rafferty, 2008). Very little research, however, has explored the theoretical roots and mechanisms of change underlying DBT.Dialectical TheoryAs a worldview, dialectical philosophy ...view middle of the document...

DBT treats the whole patient, rather than a discrete disease or disorder. When applied to the understanding of human suffering, this ontological principle of interrelatedness and wholeness leads to a systemic and contextual conceptualization of behavior (Lynch, et al., 2006). Similarly, the whole emotion system is targeted in treatment, with the recognition that all elements of the system are interrelated, influencing both the patient's behavior and the environmental context external to the patient (Lynch, et al., 2006).Cognitive-Behavioral TheoryCognitive behavioral theory assumes that an individual's cognitions play a significant and primary role in the development and maintenance of emotional and behavioral responses to life situations (Walsh, 2006). From the perspective of cognitive behavioral theory, cognitive processes are formalized in the form of meanings, judgments, appraisals, and assumptions. These processes are usually associated with specific life events and are the primary determinants of one's feelings and actions in response to life events. Thus it either facilitates or hinders the process of adaptation (Walsh, 2006).White, C. (2001). Cognitive behavioral principles in managing chronic disease.An Overview of DBT ModelDBT ComponentsDBT is a cognitive-based, support-oriented, and collaborative treatment. It includes two main components: individual weekly psychotherapy sessions and weekly group therapy sessions (Koons, 2008). The individual psychotherapist is the leader of the treatment team and is in charge of the whole treatment. Individual psychotherapy sessions emphasize solving problematic behaviors and troubles that arose in the person's life. Self-injurious and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process (Koons, 2008). Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses and helping enhance their own self-respect and self-image (Koons, 2008). The weekly group therapy sessions generally lasts for 2 to 1.5 hours and is led by a trained DBT therapist (Lynch, 2006). Group participants learn skills from four different modules: interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills (McWilliams, 2012).Cognitive-Behavioral AssessmentThe most important shortcoming in classic cognitive and behavioral treatments is that clinicians focus almost exclusively on helping patients change their thoughts, feelings, and behaviors. A treatment solely focused on change often was not palatable to these patients, who often felt invalidated and criticized and dropped out of treatment (Lynch, 2006). On the other side, a treatment focused entirely on acceptance invalidated the seriousness of the patients' suffering and the urgent need to produce change. As a result, DBT anchored in a dialectical philosophy that encourages the balance and synthesis of both acceptance and change...

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