DBT LBC ACTUAL FINALS ANSWERS AND
QUESTIONS SET A+
✔✔Within DBT skills manual, why is open groups preferred over closed groups? - ✔✔1)
closed groups allow facilitators to deviate from topics at hand and into more of a
process group
2) Open groups allow for participants to adapt to change , for example norms to change
and allows participants with trust issues to learn how to adapt and change to new
members
✔✔Within DBT skills manual, do groups have to be homogenous or heterogenous? -
✔✔While homogenous is recommended groups can be heterogenous. Examples of an
homogenous group being same diagnoses, suicidal clients etc
✔✔Within DBT skills manual, What are the cons of a homogenous group? - ✔✔1) risky
on an outpatient basis due to emotional reactivity of patients
2) tendency of highly emotional reactive clients to become emotionally involved with
others tragedies
3) lack of appropriate modeling (marsha refutes this)
4) struggle with mood dependent clients and clients picking up on the " moods" of other
clients
5) "attention seeking" behaviors (marsha has not found this to be the case)
✔✔Within DBT skills manual, 2 arguments for homogenous groups - ✔✔1) skills and
examples can be tailored more
2) source of validation from sameness
* note to skills trainers of homogenous groups, be aware of the urge to initiate
dysfunctional behaviors and the need to change ones self image from disordered ro not
disordered - beware of this judgement
✔✔What is the procedure to "are the requisite behaviors in the persons behavior
repertoire? Does she know how to do the following?
a. regulate her emotion
b. tolerate distress
,c. respond skillfully to conflict
d. observe, describe, and participate without judging with awareness and focusing on
effectiveness
e. manager her own behavior - ✔✔Behavioral skills training (Change procedures)
✔✔Any ineffective behaviors being reinforced? - ✔✔Contingency procedures (Change
procedures)
✔✔Are effective behaviors inhibited by unwavering fears or guilts? is the person
"emotion phobic?" - ✔✔Exposure (change procedures)
✔✔Are effective behaviors being inhibited by faulty beliefs or assumptions? Do these
beliefs and assumptions reliably precede ineffective behaviors? - ✔✔cognitive
modifications (change procedures)
✔✔Contingency procedures are based on the premise that - ✔✔the consequences of a
behavior effect the probability of the behavior happening again
✔✔All consequences or contingencies that increase or strengthen the probability of a
behavior - ✔✔Reinforcement
✔✔Procedures that weaken the probability of a behavior from occuring - ✔✔Extinction
or punishment
✔✔Cessation of reinforcement for a behavior that was previously reinforced -
✔✔extinction
✔✔Application of consequences that suppress the probability of behavior; any
consequence that functions as a punishment is "aversive" - ✔✔punishment
✔✔There are 2 types of contingency procedures - ✔✔!) contingency management
2) observing limits
✔✔Addresses behaviors on the behavior target list - ✔✔contingency management
✔✔addresses all P's behaviors that push or cross T's own personal limits -
✔✔observing limits
✔✔Contingency management procedures checklist: T orients P to contingency
management - ✔✔1) explain how learning takes place
2) discuss difference between attending an outcome and an outcomes being
functionally related to behavior
, ✔✔Contingency management procedures checklist: T reinforces target relevant
adaptive behaviors - ✔✔1) T makes reinforcement immediate
2) T adapts schedule of reinforcement to fit strength of P's adaptive response
a when response is weak , T reinforces P every time P emits a desired behavior
b as a response gets stronger, T gradually fades frequency and intensity of
reinforcement to an intermittent schedule
c as environmental and self managed contingencies become increasingly effective, T
gradually phases out reinforcement completely
d T uses the therapeutic relationship as a reinforcer (praises, saying they are doing well,
etc)
✔✔Contingency management procedures checklist: T extinguishes target- relevant
maladaptive - ✔✔T assess whether the behavior is being maintained by reinforcing
consequences
T does not appease
T holds to the extinction schedule during behavioral bursts
T engages P in problem solving to help her find another behavior that can be reinforced
(T rapidly reinforcers alternate adaptive behaviors)
T soothes during extinction (T is solicitous and validating of suffering. T warmly reminds
P of extinction rationale
✔✔Contingency management procedures checklist: Use aversive contingencies when
necessary - ✔✔1) when the reinforcing consequences of high priority target- relevant
behavior are not under T's control
2) When the maladaptive behavior interferes with all other adaptive behaviors
3) T uses disapproval, confrontation, or withdrawal of warmth
4) T uses correction- overcorrection (1- T withholds something C wants or adds an
aversive consequence,2 T asks P to engage in a new behavior that corrects the impacts
of the old behavior and also overcorrects the effects too,3 once the new behavior takes
place T stops the punishment
5) T uses vacation from therapy when necessary (use when all else has failed and the
behavior is so serious it crosses therapeutic and personal limits) (T needs to be clear
what behavior has to change, time must be given for P to change the behavior, results
should be presented from an observing limits perspective, once condition or time
requirement is met P can return, while P is on vacation T will touch base from time to
time, and T should provide P with a backup therapist
6) T terminates therapy as a last resort only
✔✔To use aversive punishment, the following criteria should be met - ✔✔1 behavior
being punished should be target relevant ie if its not targeted we do not punish
2.behaviors lower on the hierarchy are ignored for higher targeted items until later on
3 if extinction or reinforcing competing behaviors work just as well, aversive punishment
should not be used
QUESTIONS SET A+
✔✔Within DBT skills manual, why is open groups preferred over closed groups? - ✔✔1)
closed groups allow facilitators to deviate from topics at hand and into more of a
process group
2) Open groups allow for participants to adapt to change , for example norms to change
and allows participants with trust issues to learn how to adapt and change to new
members
✔✔Within DBT skills manual, do groups have to be homogenous or heterogenous? -
✔✔While homogenous is recommended groups can be heterogenous. Examples of an
homogenous group being same diagnoses, suicidal clients etc
✔✔Within DBT skills manual, What are the cons of a homogenous group? - ✔✔1) risky
on an outpatient basis due to emotional reactivity of patients
2) tendency of highly emotional reactive clients to become emotionally involved with
others tragedies
3) lack of appropriate modeling (marsha refutes this)
4) struggle with mood dependent clients and clients picking up on the " moods" of other
clients
5) "attention seeking" behaviors (marsha has not found this to be the case)
✔✔Within DBT skills manual, 2 arguments for homogenous groups - ✔✔1) skills and
examples can be tailored more
2) source of validation from sameness
* note to skills trainers of homogenous groups, be aware of the urge to initiate
dysfunctional behaviors and the need to change ones self image from disordered ro not
disordered - beware of this judgement
✔✔What is the procedure to "are the requisite behaviors in the persons behavior
repertoire? Does she know how to do the following?
a. regulate her emotion
b. tolerate distress
,c. respond skillfully to conflict
d. observe, describe, and participate without judging with awareness and focusing on
effectiveness
e. manager her own behavior - ✔✔Behavioral skills training (Change procedures)
✔✔Any ineffective behaviors being reinforced? - ✔✔Contingency procedures (Change
procedures)
✔✔Are effective behaviors inhibited by unwavering fears or guilts? is the person
"emotion phobic?" - ✔✔Exposure (change procedures)
✔✔Are effective behaviors being inhibited by faulty beliefs or assumptions? Do these
beliefs and assumptions reliably precede ineffective behaviors? - ✔✔cognitive
modifications (change procedures)
✔✔Contingency procedures are based on the premise that - ✔✔the consequences of a
behavior effect the probability of the behavior happening again
✔✔All consequences or contingencies that increase or strengthen the probability of a
behavior - ✔✔Reinforcement
✔✔Procedures that weaken the probability of a behavior from occuring - ✔✔Extinction
or punishment
✔✔Cessation of reinforcement for a behavior that was previously reinforced -
✔✔extinction
✔✔Application of consequences that suppress the probability of behavior; any
consequence that functions as a punishment is "aversive" - ✔✔punishment
✔✔There are 2 types of contingency procedures - ✔✔!) contingency management
2) observing limits
✔✔Addresses behaviors on the behavior target list - ✔✔contingency management
✔✔addresses all P's behaviors that push or cross T's own personal limits -
✔✔observing limits
✔✔Contingency management procedures checklist: T orients P to contingency
management - ✔✔1) explain how learning takes place
2) discuss difference between attending an outcome and an outcomes being
functionally related to behavior
, ✔✔Contingency management procedures checklist: T reinforces target relevant
adaptive behaviors - ✔✔1) T makes reinforcement immediate
2) T adapts schedule of reinforcement to fit strength of P's adaptive response
a when response is weak , T reinforces P every time P emits a desired behavior
b as a response gets stronger, T gradually fades frequency and intensity of
reinforcement to an intermittent schedule
c as environmental and self managed contingencies become increasingly effective, T
gradually phases out reinforcement completely
d T uses the therapeutic relationship as a reinforcer (praises, saying they are doing well,
etc)
✔✔Contingency management procedures checklist: T extinguishes target- relevant
maladaptive - ✔✔T assess whether the behavior is being maintained by reinforcing
consequences
T does not appease
T holds to the extinction schedule during behavioral bursts
T engages P in problem solving to help her find another behavior that can be reinforced
(T rapidly reinforcers alternate adaptive behaviors)
T soothes during extinction (T is solicitous and validating of suffering. T warmly reminds
P of extinction rationale
✔✔Contingency management procedures checklist: Use aversive contingencies when
necessary - ✔✔1) when the reinforcing consequences of high priority target- relevant
behavior are not under T's control
2) When the maladaptive behavior interferes with all other adaptive behaviors
3) T uses disapproval, confrontation, or withdrawal of warmth
4) T uses correction- overcorrection (1- T withholds something C wants or adds an
aversive consequence,2 T asks P to engage in a new behavior that corrects the impacts
of the old behavior and also overcorrects the effects too,3 once the new behavior takes
place T stops the punishment
5) T uses vacation from therapy when necessary (use when all else has failed and the
behavior is so serious it crosses therapeutic and personal limits) (T needs to be clear
what behavior has to change, time must be given for P to change the behavior, results
should be presented from an observing limits perspective, once condition or time
requirement is met P can return, while P is on vacation T will touch base from time to
time, and T should provide P with a backup therapist
6) T terminates therapy as a last resort only
✔✔To use aversive punishment, the following criteria should be met - ✔✔1 behavior
being punished should be target relevant ie if its not targeted we do not punish
2.behaviors lower on the hierarchy are ignored for higher targeted items until later on
3 if extinction or reinforcing competing behaviors work just as well, aversive punishment
should not be used
