An Introduction to DBT - Professor Michaela Swales
Aug 14, 2023
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Professor Michaela Swales, a leading expert in Dialectical Behavior Therapy (DBT), discusses the integration of Eastern and Western philosophy in DBT, the therapeutic benefits of viewing thoughts and emotions as behaviors, and the four core elements of DBT. She also shares insights on addressing hopelessness in therapy, recommendations for therapists, and the initial steps involved in DBT training and delivery.
DBT combines the principles of behaviorism and Zen mindfulness, aiming to help individuals with intense emotion dysregulation and maladaptive behaviors.
DBT consists of four key elements: skills group, individual therapy, phone coaching, and consultation team meetings.
DBT goes beyond symptom reduction and focuses on helping individuals create a life worth living by understanding and addressing underlying problems.
Deep dives
DBT: Combining Eastern and Western Philosophy
DBT, or dialectical behavior therapy, is an evidence-based psychological treatment that combines the principles of behaviorism and Zen mindfulness. It aims to help individuals with intense emotion dysregulation and maladaptive behaviors. DBT focuses on teaching skills to manage emotions, crises, and interpersonal relationships through a skills group component, individual therapy, and coaching between sessions. The therapy also emphasizes the importance of validating and accepting emotions while working towards a life worth living. DBT is especially effective for individuals with conditions like borderline personality disorder and suicidal tendencies.
The Four Elements of DBT
DBT consists of four key elements: skills group, individual therapy, phone coaching, and consultation team meetings. The skills group component focuses on acquiring new skills to manage emotions, distress, and interpersonal relationships. Individual therapy helps clients understand the controlling variables behind their problematic behaviors and tailor skills to address those issues. Phone coaching allows clients to reach out to their therapists for support and guidance in applying skills during real-life situations. Lastly, the consultation team meetings provide therapists with support and guidance in delivering effective therapy.
Acting Opposite to Action Urges
DBT recognizes that emotions often drive action urges, such as avoidance or aggression. The therapy encourages clients to act opposite to these action urges when they are not warranted or hinder the individual's progress. By going against the action urges associated with emotions like fear, anger, sadness, or shame, individuals can regulate their emotions and work towards desired outcomes. However, it is essential to assess if the emotion and its intensity align with the current situation and individual values, as sometimes the emotion itself signifies a valid response.
A Focus on a Life Worth Living
DBT goes beyond symptom reduction and aims to help individuals create and pursue a life worth living. The therapy prioritizes understanding and addressing the underlying problems that lead to suicidal ideation or maladaptive behaviors. Therapists guide clients in identifying meaningful goals and supporting them in moving towards a more fulfilling life. It also involves determining when to take therapeutic risks, deviating from restrictive measures, and encouraging clients to face challenges in order to improve their quality of life.
Recommended Materials for Further Learning
For therapists interested in DBT, 'Regulating Emotion the DBT Way' by Christine Dunkley provides valuable insights into emotion regulation techniques. 'Distinctive Features of DBT' by Michaela Swales and Heidi L. Heard offers an overview of the key aspects of DBT. Additionally, 'How to Do DBT' by Kelly Koerner provides a practical guide for implementing DBT techniques in therapy. Finally, Marcia Linehan's memoir, 'Life Worth Living,' offers a personal account of her experiences and insights in developing DBT.
Professor Michaela Swales - a consultant clinical psychologist, author, and DBT trainer, who has trained more than 1,000 professionals in the approach. There are few people on the planet who know as much about DBT as Michaela, so it was a real delight to have this conversation with her, in which we cover:
— How DBT combines the best of Eastern and Western Philosophy into one modality, and what Michaela learned from training under Marsha Linehan
— Why everything (including thoughts and emotions) can be thought of as behaviours and the therapeutic benefits of this perspective
— The 4 core elements of DBT, including how the therapy is structural, and why DBT requires a team or community of therapists
And more…
You can learn more about DBT training by going to www.dbt-training.co.uk, and pick up a copy of Michaela’s book here: https://amzn.to/3QU3ZeN.
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Michaela Swales, PhD, is a Consultant Clinical Psychologist with BCUHB and Reader in Clinical Psychology on the North Wales Clinical Psychology Programme at Bangor University. She trained in Dialectical Behaviour Therapy in Seattle in 1994 and 1995 with Marsha Linehan and for twenty years ran a clinical programme for suicidal young people in an inpatient service.
After completing specialist supervision in DBT, she became one of the founder members of the UK DBT Training Team in 1997 and Director of the Training Team in 2002. She has trained more than a thousand professionals in DBT, seeding over 400 programmes, in both the UK and further afield. She is the co-author of Dialectical Behaviour Therapy: Distinctive Features, which had its second edition published by Routledge in 2016 and Changing Behavior in DBT: Problem-Solving in Action, published by Guilford in 2015.
Interview Links:
— www.dbt-training.co.uk
— Marsha Linehan: https://en.wikipedia.org/wiki/Marsha_M._Linehan
3 Books Prof. Swales Recommends Every Therapist Should Read:
— Regulating Emotion the DBT Way - Christine Dunkley: https://amzn.to/3LnAEso
— DBT: Distinctive Features - Michaela Swales & Heidi Heard: https://amzn.to/3QU3ZeN
— Building a Life Worth Living: A Memoir - Marsha Linehan: https://amzn.to/3QNfdly
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