DBT FINAL EXAM QUESTIONS & ANSWERS
For what population was DBT originally developed? How has DBT developed over the
years? - Answer -Borderline personality disorder
Severe and chronic, multi-diagnostic, difficult-to-treat clients
It has expanded to include other populations where the common feature is emotion
dysregulation
What are the different modes of DBT treatment? What functions do they serve? -
Answer -1. Individual therapy
Function: Improve motivation
Weekly
50 minutes
Sessions can be extended based on therapeutic work being done
First 4 sessions determine compatibility:
- Initial assessment - SCID, UWRAP/UWRAMP, outcome measures
- 2 sessions, 1-2 hours
- Follow-up - 90 minutes
- Then 4 pre-treatment sessions
2. Skills training
Function: Enhance capabilities
Teach, practice, and reinforce skills because too difficult to do within individual
Acceptance Skills:
- Mindfulness: Observe, describe, participate, non-judgmentally, one mindfully,
effectively
- Distress tolerance
Change Skills:
- Emotion regulation
- Interpersonal effectiveness
3. Telephone Consultation
Function: Generalization of skills
Helps generalize new behavior, extinguish maladaptive behavior in daily environment
Helps manage crises, generalize skills, and repair/build the relationship
Difficulty: asking for help & asking effectively
Builds therapeutic relationship
Cannot contact for 24 hours after self-harm incident
4. Team consultation
Function: Environmental intervention, maintain skills and motivation of treatment
providers
Provides support
Improve adherence
Everyone on team must be actively seeing a client
,No one is teaching - collaborative and everyone is vulnerable
5. Ancillary treatments
Medications, hospitalization, vocational/occupational counseling, AA, case
management, etc
What is standard/comprehensive DBT? How long was this originally thought to last? -
Answer -Standard/comprehensive DBT is:
Stage 1 - focus on SI & skills classes/ groups
All 4 modes
Individual
Skills
Coaching
Team consultation
Supposed to last one year
DBT is a principle-based treatment that incorporates protocols. Describe what that
means. - Answer -Principles tell you how to figure out what to do
- Hierarchy (stages)
- Modularity (4 modes and components in each)
- Case formulation approach
- Behavioral assessment
- Dialectics
Protocols are "one-size-fits-all" approaches & has instructions
The principles of DBT inform what protocol to use
There is one protocol required in DBT. What is it? - Answer -Reducing suicidal
behaviors (unsure if this is the right answer)
Comprehensive or adherent protocol DBT treatment requires that the DBT clients and
providers engage in all four components of DBT (unsure if this is the right answer)
Summarize what an individual therapy (non-pretreatment) looks like? How's it start, how
is it run, how does it end? - Answer -1. Begins warm & inviting
- Emotional state & relationship repair
2. Review diary card, homework, set the agenda, and check in on other modes
3. UWRAP (University of Washington Risk Assessment Protocol) start session
4. When ending
- Sufficient time - notice, coping with ending session, close up emotionally
- Review homework or other tasks for the week
- When appropriate, summarize session
- If relevant, give client copy of session
- Encourage and cheerlead client's ability to progress and handle difficulties while
validating real difficulties
- Soothe client and remind of therapist's continuous presence and availability
- Troubleshoots where necessary for expected difficulties
- Stand and part with client with warmth and expectation to meet again soon
, -Other ending rituals developed for client as needed
What are the four stages/levels of DBT (see ch. 4 sides)? Which stage is the most
heavily researched? - Answer -Determined based on imminent threat, disability,
complexity, pervasiveness, & severity
1. severe behavioral dyscontrol:
Treatment - behavioral control
Failures in survival and safety
Severe disinhibition, externalizing behavior, quality of life interfering behaviors
Incapacitating disorders
Ex: suicidal attempt, homicidal rage, florid psychosis, homeless heroin addict, catatonic
depression
Imminent threat & disability are high
2 . quiet desperation:
Treatment - emotional experiencing
Severe neuroticism
Internalizing disorders
Sense of safety
Ex: PTSD, BPD, maladaptive bereavement
Imminent threat is low, disability is low-moderate, complexity and pervasiveness are
high
3. problems in living:
Treatment - ordinary happiness & unhappiness
Uncomplicated, circumscribed Axis 1 disorder (panic disorder, ODC, depression, eating
disorders, etc)
Marital problems
Career problems
Everything is low except pervasiveness (low-mod) and severity (low-high)
4. incompleteness:
Treatment - capacity for joy and freedom
Existential concerns
Emptiness
Malaise/meaninglessness
Spiritual dryness
Loneliness/non-attachment
Imminent threat, disability, & complexity are absent
Pervasiveness & severity can be low-high
What is the DBT treatment hierarchy? - Answer -- Defines priority and focus
- Guides what to focus on in treatment
Stages of treatment:
Stage 1: focused on SI, skills development
For what population was DBT originally developed? How has DBT developed over the
years? - Answer -Borderline personality disorder
Severe and chronic, multi-diagnostic, difficult-to-treat clients
It has expanded to include other populations where the common feature is emotion
dysregulation
What are the different modes of DBT treatment? What functions do they serve? -
Answer -1. Individual therapy
Function: Improve motivation
Weekly
50 minutes
Sessions can be extended based on therapeutic work being done
First 4 sessions determine compatibility:
- Initial assessment - SCID, UWRAP/UWRAMP, outcome measures
- 2 sessions, 1-2 hours
- Follow-up - 90 minutes
- Then 4 pre-treatment sessions
2. Skills training
Function: Enhance capabilities
Teach, practice, and reinforce skills because too difficult to do within individual
Acceptance Skills:
- Mindfulness: Observe, describe, participate, non-judgmentally, one mindfully,
effectively
- Distress tolerance
Change Skills:
- Emotion regulation
- Interpersonal effectiveness
3. Telephone Consultation
Function: Generalization of skills
Helps generalize new behavior, extinguish maladaptive behavior in daily environment
Helps manage crises, generalize skills, and repair/build the relationship
Difficulty: asking for help & asking effectively
Builds therapeutic relationship
Cannot contact for 24 hours after self-harm incident
4. Team consultation
Function: Environmental intervention, maintain skills and motivation of treatment
providers
Provides support
Improve adherence
Everyone on team must be actively seeing a client
,No one is teaching - collaborative and everyone is vulnerable
5. Ancillary treatments
Medications, hospitalization, vocational/occupational counseling, AA, case
management, etc
What is standard/comprehensive DBT? How long was this originally thought to last? -
Answer -Standard/comprehensive DBT is:
Stage 1 - focus on SI & skills classes/ groups
All 4 modes
Individual
Skills
Coaching
Team consultation
Supposed to last one year
DBT is a principle-based treatment that incorporates protocols. Describe what that
means. - Answer -Principles tell you how to figure out what to do
- Hierarchy (stages)
- Modularity (4 modes and components in each)
- Case formulation approach
- Behavioral assessment
- Dialectics
Protocols are "one-size-fits-all" approaches & has instructions
The principles of DBT inform what protocol to use
There is one protocol required in DBT. What is it? - Answer -Reducing suicidal
behaviors (unsure if this is the right answer)
Comprehensive or adherent protocol DBT treatment requires that the DBT clients and
providers engage in all four components of DBT (unsure if this is the right answer)
Summarize what an individual therapy (non-pretreatment) looks like? How's it start, how
is it run, how does it end? - Answer -1. Begins warm & inviting
- Emotional state & relationship repair
2. Review diary card, homework, set the agenda, and check in on other modes
3. UWRAP (University of Washington Risk Assessment Protocol) start session
4. When ending
- Sufficient time - notice, coping with ending session, close up emotionally
- Review homework or other tasks for the week
- When appropriate, summarize session
- If relevant, give client copy of session
- Encourage and cheerlead client's ability to progress and handle difficulties while
validating real difficulties
- Soothe client and remind of therapist's continuous presence and availability
- Troubleshoots where necessary for expected difficulties
- Stand and part with client with warmth and expectation to meet again soon
, -Other ending rituals developed for client as needed
What are the four stages/levels of DBT (see ch. 4 sides)? Which stage is the most
heavily researched? - Answer -Determined based on imminent threat, disability,
complexity, pervasiveness, & severity
1. severe behavioral dyscontrol:
Treatment - behavioral control
Failures in survival and safety
Severe disinhibition, externalizing behavior, quality of life interfering behaviors
Incapacitating disorders
Ex: suicidal attempt, homicidal rage, florid psychosis, homeless heroin addict, catatonic
depression
Imminent threat & disability are high
2 . quiet desperation:
Treatment - emotional experiencing
Severe neuroticism
Internalizing disorders
Sense of safety
Ex: PTSD, BPD, maladaptive bereavement
Imminent threat is low, disability is low-moderate, complexity and pervasiveness are
high
3. problems in living:
Treatment - ordinary happiness & unhappiness
Uncomplicated, circumscribed Axis 1 disorder (panic disorder, ODC, depression, eating
disorders, etc)
Marital problems
Career problems
Everything is low except pervasiveness (low-mod) and severity (low-high)
4. incompleteness:
Treatment - capacity for joy and freedom
Existential concerns
Emptiness
Malaise/meaninglessness
Spiritual dryness
Loneliness/non-attachment
Imminent threat, disability, & complexity are absent
Pervasiveness & severity can be low-high
What is the DBT treatment hierarchy? - Answer -- Defines priority and focus
- Guides what to focus on in treatment
Stages of treatment:
Stage 1: focused on SI, skills development
