Dialectical Behavior Therapy: A Visual Review Skills Flash ...

1 Dialectical Behavior Therapy: A Visual Review Skills Flash Cards These cards are helpful in familiarizing both clients and therapists with the Skills Modules within DBT and may be used in conjunction with Skills Group or Individual Therapy. The cards are helpful for clients to use as a quick reference while they are busy living their daily lives. The images found within are from the Dialectical Behavior Therapy: A Visual Review presentation. The cards were created by Dr. Steve McCandless, and Stephanie Johnston, LCSW of the Cen- tral Arkansas Veterans Healthcare System in collaboration with artist Kevin Cates. The project was made possible through a grant from the South Central MIRECC.

2 Please feel free to use and distribute the cards as needed. Instructions for Use Print the following pages then copy front and back onto one page. Make sure the numbers 1' and 2' are on opposite sides of the first page and in the same loca- tion. Once printed cut along the dotted lines and put in sequential order. Blank cards are numbered 63-71 and are included for notes if desired. The cards can be stapled together or laminated with a hole punch in the top left corner and placed on a key ring, 1 3 BioSocial Model 5. Dialectical BioSocial Behavior Theory Therapy Flash Cards for Skills Use Emotionally Sensitive Baby + Invalidating Environment 7 9 11. Dialectical Dilemma Dialectical Dilemma Dialectical Dilemmas Unrelenting Crisis Emotional Vulnerability 6 4 2.

3 BioSocial Theory Borderline Personality Sensitive Child +. Disorder Invalidating Environment What is DBT? =. Borderline Personality Disorder DBT was developed in the mid-1990's by Dr. Marsha 1. Fear of Abandonment Linehan. It combines both person-centered therapy based 2. Chaotic Relationships on acceptance with cognitive behavioral therapy based on change. This dialectic of change and acceptance remains 3. Identity Disturbance core to the treatment. It is comprised of Skills Training in 4. Impulsivity Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness as well as Individual Therapy. 5. Suicidal or Self Harm Behavior In Individual Therapy diary cards and a target hierarchy 6.

4 Mood Instability are used to organize sessions. 7. Feelings of Emptiness 8. Intense Anger 9. Stress related Paranoia 12 10 8. Dialectical Dilemma Dialectical Dilemma Dialectical Dilemmas Or Secondary Targets Unrelenting Crisis vs Inhibited Grief Emotional Vulnerability vs Self Invalidation Active Passivity vs Apparent Competence Self Invalidation Inhibited Grief 13 15 17. Dialectical Dilemma Opposite Action Skill Emotion Emotion: Regulation Skills Shame Active Passivity Opposite Action Skill 19 Opposite Action Skill 21 Opposite Action Skill 23. Shame Anger Emotion: Anger Action Urge: Action Urge: Hide Attack 18 Opposite Action Skill 16 14. Dialectical Dilemma Shame Goals of Emotion Regulation Understand and name your own emotions.

5 Decrease the frequency of unwanted emotions. Decrease emotional vulnerability. Decrease vulnerabil- ity to emotion mind. Increase resilience, your ability to cope with difficult things and positive emotions. Decrease emotional suffering. Reduce suffering when painful emotions overcome you. Manage extreme emotions so that you don't make things worse. Justified: Apparent Competence Violated Group Moral 24 22 Opposite Action Skill 20 Opposite Action Skill Opposite Action Skill Anger Shame Anger Opposite Action: 1. Step Back Justified: Opposite Action: 2. Be Kind Goal Blocked Be Proud, show Up Opposite Action Skill 27 29. 25. Sadness Opposite Action Skill Opposite Action Skill Emotion: Emotion: Sadness Fear Action Urge: Isolate Opposite Action Skill Opposite Action Skill 31 33 35.

6 Fear Joy Opposite Action Skill Emotion: Joy Action Urge: Action Urge: Avoid Repeat 30 Opposite Action Skill 28 Opposite Action Skill 26 Opposite Action Skill Fear Sadness Sadness Justified: Opposite Action: Justified: Danger Engage Loss 36 Opposite Action Skill 34 Opposite Action Skill 32 Opposite Action Skill Joy Joy Fear Opposite Action: Justified: Opposite Action: Avoid Improves Life Approach Interpersonal Effectiveness Interpersonal Effectiveness 39 41. 37. GIVE Skill DEAR MAN Skill Interpersonal Effectiveness Skills To Keep Relationships To Obtain Your Objective Mindfulness Skill Interpersonal Effectiveness 43 45 47. Wise Mind FAST Skill Mindfulness Skills The Middle Path To Keep Self Respect between Emotional Mind and Rational Mind Interpersonal Effectiveness Interpersonal Effectiveness 38.

7 42 40 Goals of DEAR MAN Skill GIVE Skill Interpersonal Effectiveness Be skillful in getting what you want and need from others. Get others to do things you would like them to do. Get oth- Describe: the situation. Gentle: No attacks, threats, judging, or non- ers to take your opinions seriously. Say no to unwanted re- verbal cues of eye rolling or smirking. Express: your feelings. quests. Build relationships and end destructive ones. Interested: Don't interrupt, maintain good eye Strengthen current relationships. Don't let hurts and prob- Assert: what you want to happen. contact. lems build up. Use relationship Skills to head off problems. Repair relationships when needed. Resolve conflicts before Reinforce: the consequences both positive and negative.

8 Validating: show that you understand the they get overwhelming. Find and build new relationships. Mindful: be a broken record, don't get distracted. other person. See the world from their point of End hopeless relationships. Walk the middle path. Create view. Put yourself in their shoes. and maintain balance in relationships. Balance acceptance Appear confident: Hold your ground. and change in relationships. Easy manner: Stay light hearted and smile. Negotiate: Cooperate & be fair. To Obtain Your Objective To Keep Relationships Interpersonal Effectiveness 48 46 44. Mindfulness Skill FAST Skill Goals of Mindfulness be Fair: to yourself and others. Reduce suffering and increase happiness.

9 Reduce no Apologies: don't look ashamed, keep your Wise Mind pain, tension, and stress head and eyes up, no apologizing for being alive or for making a request. Increase control of your mind. Stop letting your mind be in control of you. Stick to values: don't sell out your integrity. Experience reality as it is. Live life with your eyes Stick to your guns. wide open. Experience the reality of your connection be Truthful: Don't lie or act helpless when to the universe, essential goodness, essential validity. you're not. To Keep Self Respect Emotional Mind Rational Mind Mindfulness Skill 49 51. T 53. Rational Mind Distress Tolerance: TIPP Skill Distress Excessive = Cold, Tolerance Over-regulated, Skills and Robotic Temperature I 55.

10 P 57 P 59. Distress Tolerance: TIPP Skill Distress Tolerance: TIPP Skill Distress Tolerance: TIPP Skill Paced Breathing: progressive Intense Exercise In Through the Nose Muscle Relaxation 54 T 52 50. Mindfulness Skill Distress Tolerance: TIPP Skill Emotional Mind Tip the Temperature of your face Goals of with cold water to calm down fast. Distress Tolerance Holding your breath, put your face in a Survive Crisis Situations without making them worse. bowl of cold water, or hold a cold pack Accept Reality: replace suffering and being stuck with on your eyes and cheeks. ordinary pain and the possibility of moving forward. Hold for 30 seconds. Become Free: of having to satisfy the demands of your Caution: Very cold water can decrease own desires, urges, and intense emotions.