What are the assumptions of treatment? (8) - Answers 1. Patients are doing the best they can
2. Patients want to improve
3. Patients need to do better, try harder, and be more motivated to change
4. Patients may not have caused all of their own problems, but they have to solve them anyway
5. The lives of suicidal, borderline individuals are unbearable as they are currently being lived
6. Patients must learn new behaviors in all relevant contexts
7. Patients cannot fail in therapy
8. Therapists treating borderline patients need support
Stages of Treatment and Targets - Pre Tx - Answers Pre-Tx: Commitment and Agreement
orient to treatment
agree on goals
Stages of Treatments and Targets - Stage 1 - Answers Stage 1: Severe Behavioral dysfunction
behavioral control
Life threatening
Treatment interfering
Quality of life interfering
Behavioral skills
Stages of Treatments and Targets - Stage 2 - Answers Stage 2: quiet desperation Non-
anguished emotional experiencing
PTSD
Emotion dysregulation
Stages of Treatments and Targets - Stage 3 - Answers Stage 3: problems in living ordinary
happiness
Respect for self
Individual Goals
Stages of Treatments and Targets - Stage 4 - Answers Stage 4: incompleteness capacity for joy
, and freedom
Enhanced performance
Characteristics of an Invalidating Environment - Answers Rejection of private
experiences/behaviors
Intermittent reinforcement of escalated emotional display
Oversimplification of problem solving - "just try harder"
Features of Emotional Vulnerability - Answers High sensitivity to emotional cues
High reactivity (intense emotions)
Slow return to baseline
4 Characteristics of having emotional modulation - Answers 1. (physical) ability to increase or
decrease physical arousal associated w/
2. (attentional) ability to redirect/refocus attention in presence of
3. (behavioral) ability to block or inhibit impulsive actions related to
4. (behavioral) ability to stay on task to achieve non-mood dependent goal
Secondary Dialectical Dilemmas - Answers Unrelenting crisis (bio) vs. inhibited grieving
Emotional vulnerability (bio) vs. self-invalidation
Active passivity (bio) vs. apparent competence
6 Levels of Validation - Answers V1: active presence
V2: accurate reflection
V3: mindreading
V4: understanding in terms of history
V5: understanding in terms of present (normalizing, context)
V6: radical genuineness
4 Types of Validation Strategies - Answers emotional
behavioral
cognitive