Dialectical Behavior Therapy Skills Training Workbook3

7/23/2019 Dialectical Behavior Therapy Skills Training Workbook3

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Dialectical Behavior Therapy Skills TrainingFor Emotion Dysregulation

Student Workbook

Rachel Gill


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Table of Contents

TABLE OF CONTENTS 2

PREFACE 5

INTRODUCTION TO DBT PEER CONNECTIONS SKILLS TRAINING 6

SKILLSTRAIIG!"#RSE"$ER$IE% &DBT 'EER!"DE"F!"D#!T (T)EBI"S"!IAL*"DELF"RE*"TI"D+SREG#LATI" ,DBT %ISE*ID)AD"#T -TI' !RISISS#R$I$ALSKILLS)AD"#T. STRATEG+%"RKS)EET //ITR"D#!TI"T"DIALE!TI!ALBE)A$I"RT)ERA'+$IDE". 0#I1 /2DBT DIAR+!ARD/ /3

SETTING PERSONAL GOALS & MAINTAINING MOTIVATION 15

S*ART G"ALS /&$ITALS SKILLS /&S*ART G"AL$ITALS %"RKS)EET /(DBT & LE$ELS"F$ALIDATI")AD"#T /,DBT & LE$ELS"F$ALIDATI"%"RKS)EET /-DIAR+!ARD%EEK2 24

CORE MINDFULNESS SKILLS 21

5%)AT6 SKILLS 2/5)"%6 SKILLS 27*IDF#LESS8 A DAIL+'RA!TI!E 29*IDF#LESSSKILLS%"RKS)EET 2&DBT DIAR+!ARD7 2(

REALITY ACCEPTANCE SKILLS 28

RADI!ALA!!E'TA!E 2,T#RT)E*ID 2,%ILLIGESS 2-%ILLF#LESS 2-

RADI!ALA!!E'TA!E 74RADI!ALA!!E'TA!E%"RKS)EET 7/REALIT+A!!E'TA!ESKILLS0#I1 72*IDF#LESST"%ILLIGESS. %ILLF#LESS%"RKS)EET 73L"$IGKIDESS 79DIAR+!ARD%EEK3 7&

DISTRESS TOLERANCE SKILLS OVERVIEW 37

2


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ST"' SKILLS 7,ST"' SKILLSSTRATEG+%"RKS)EET 7-A!!E'TS SKILLS 34A!!E'TS SKILLS%"RKS)EET 3/I*'R"$E SKILLS)AD"#T 32

I*'R"$E SKILLS%"RKS)EET 37*AKEASELF:S""T)EKIT)"*E%"RK 39DIAR+!ARD%EEK9 3&

EMOTION REGULATION SKILLS 47

IDETIF+IG; LABELIG. F#!TI"S"FE*"TI"S 3(*+T)SAB"#TE*"TI"S)"*E%"RK 3(DIAR+!ARD%EEK& 3-

CHECK THE FACTS OF EMOTIONAL RESPONSES 50

!)E!KT)EFA!TS%"RKS)EET 92DIAR+!ARD%EEK( 97

OPPOSITE TO EMOTION ACTION 54

"''"SITEA!TI")"*E%"RK 9&%"RKIG%IT)'RI*AR+. SE!"DAR+E*"TI"S 9(DIAR+!ARD%EEK, 9,

BEHAVIOR CHAIN ANALYSIS & SOLUTIONS 59

DES!RIBIGLIKS. GEERATIGSKILLSS"L#TI"S &4

!"'IGA)EADT"'RE$ETF#T#RETARGETBE)A$I"R &2DIAR+!ARD%EEK- &7

ABC PLEASE SKILLS 64

AB! SKILLS &3'LEASE SKILLS &9AB! 'LEASE )"*E%"RK &&DIAR+!ARD%EEK/4 &(

INTERPERSONAL EFFECTIVENESS SKILLS 68

DEAR *A GI$E FAST %"RKS)EET (/DIAR+!ARD%EEK// (7

COURSE REVIEW 74

'ERS"AL'EERE*'"%ER*ET'LA (9DIAR+!ARD%EEK/2 (&

7


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DBT RESOURCES 77

DBT S*ART')"EA''SRE$IE%S ((

GLOSSARY 86

APPENDIX 88

DBT PEER CONNECTIONS CONTACT INFORMATION 89

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Preface

%hen Dr< *arsha Linehan; the =oun>er Dialectical BehaviorTherapy ?DBT@; recently came out aout her struggles inyouth ith suici>e an> psychiatric institutionaliCation;

having similar eperiences in my li=e; it cause> me torealiCe that ust as my mental health prolemscoul> >estroy me; so coul> they e myre>emption< Thus; I as inspire> to =ollo Dr a ay out o=hell an> am on my ay to ecoming a DBTresearcher an> practitioner so that I may learnan> teach others ho to uil> lives orth livingthrough DBT ust as Dr< Linehans ork has >one =or meerline personality >isor>er

?B'D@ is a mark o= shame; >isparaging those ho ear the >iagnosis y theimplicative nature o= the term or>erline itsel=; ut I can honestly say thatreceiving the >iagnosis o= B'D as one o= the est things that everhappene> to me< I alays kne >eep >on that there as more to myemotional health than ust the >epression >iagnosis I receive> at /7 then /3at a chil>rens psychiatric ar>; an> then the slue o= therapists that treate>me eteen the ages o= /3:23< In =act; I as so appreciative hen I receive>the B'D >iagnosis that I >i> something that o=ten puCCles those aroun> mehom I tell my story< I sent the social orker that correctly >iagnose> meith B'D a ouHuet o= oers an> a thank you car> to econtrolle>; e are people in nee> o= support; compassion; an> treatmentsthat ork< kin>ness;

Rachel Gill ?aka 'inki Tusca>erro@DBT 'eer *entor; B'D 'eer A>vocate;email8ilove>tJgmail


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Introduction to DBT Peer Connections SkillsTraining

Skills Training Course Overview

This orkook is a comprehensive sel=:help orkook =or learning >ialecticalehavior therapy skills =rom a peer perspective=ulness Skills

/ Intro>uction to The Bio:social *o>el; %ise *in> . TI' !risis Skills2 S*ART Goals . $ITALS Skills . the & Levels o= $ali>ation7 !ore *in>=ulness8 %hat an> 5)o6 Skills3 Reality Acceptance Skills8 Turn The *in>; Ra>ical Acceptance;

%illingness; Loving Kin>ness

Distress Tolerance Skills

9 ST"' A!!E'TS an> I*'R"$E Skills

Emotion Regulation Skills

& I>enti=y; Lael an> Function o= Emotions

( !heck the Facts o= Emotional Responses, "pposite to Emotion Action =or #nustie> Emotions- 'rolem Solving Emotions . Behavior !hain Analysis/4 AB! 'LEASE Skills

Interpersonal EMectiveness

// DEAR *A GI$E FAST Skills/2 DBT Skills Revie . 'ersonal 'eer Empoerment 'lans

&


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DBT Peer Code of Conduct

/ Group memers agree to >o the est they can an> to ork har> to >oetter that this programis not oMere> in a pro=essional capacity; ut =rom sel=:i>entie> peers inmental health recoveryoes not mean to replace Hualie> mental health careservices

3 Group memers agree to complete the courseenti=yingin=ormation to e use> =or the purpose o= research an>or improving the

courseiscussions relate> to skills training an>ill e respect=ul in interacting ith one anothere the group any in=ormation aout other memers

that oul> violate privacy or trusting each other outsi>e o= grouphile completing skills training in or>er to preserve the unity o= thegroup >irectly; heshe ill >irect concerns to the group lea>er or co:lea>ers through the Lets talk =unctiongmental space =or learning an> sharingN e usemin>=ulness to practice a non:u>gmental stance toar> each other; theorl>; an> ourselvesal; they agree to seek help e=ore acting onurges< +ou agree to seek help =rom =rien>s; =amily; or y calling the=olloing numer =or the national suici>e hotline< /:,44:2(7:TALK ?,299@

(


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T'e Biosocial Model for )motion D(sregulationEmotion Dysregulation is a >ys=unction cause> y a transaction o= incompatileiological an> environmental =actors ithin the emotion regulation system< Theprimary iological =actor is emotion vulnerability, hich consists o= Huick; strong;an> long:lasting emotional reactions< The environmental =actor consists o= aninvalidating rearing environment, hich >oes not acknole>ge or teach theemotionally vulnerale chil> ho to manage intense an> or >iOcult emotions Breathing

TI' stan>s =or Temperature, Intense physical activity, an>paced breathingyQs senses< In the case o= emotions; theyare not simply 5in your hea>6 ut part o= a =ull system response< This meansthat hen an emotional eperience occurs; there is a mo>e o= action< Theseactions may occur ith or ithout our aareness< ?See Graphic Belo your circulatory system respon>s y increasing yourrate an> raising your o>y temperatureN the o>y respon>s to the anger

ithout conscious actionea ehin> the eMectiveness o= TI' skills is that ust as the o>yrespon>s to emotions so >oes our emotions respon> to our o>y< ?Seegraphic eloy chemistry;so to speak; e can shi=t prolematic emotional responses< %hat is more; the=act that TI' skills reHuire little logical reasoning makes them easier to apply=or those ith limite> skills trainingout an> strategy orksheet< The han>out>enes each o= the TI' skills; generally an> then oMers eamples o= ho toapply them< The orksheet >irects you in ho to create a personal TI' crisisskills strategy an> apply it< +ou shall apply your TI' skills strategy the nettime you notice you are ecoming emotionally >ysregulate>< +ou ill recor>your level o= >istress on a scale o= 4:/44 e=ore an> a=ter applying your

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strategy

&< *arsha Linehan originally create> DBT to treat UUUUUUUUUUUUUUUal ehavior

B Bor>erline personality >isor>er

! Eating >isor>ers

D Depression

(< An invali>ating environment means that its the parents =ault hen aperson >evelops or>erline personality >isor>erule taught is UUUUUUUUUUUUUUUUUU=ulness Skills

-< The name o= the clinical manual y *arsha Linehan that outlines DBTis !ognitive:Behavioral Treatment o= Bor>erline 'ersonality Disor>ererline personality>isor>er

A Emotion >ysregulation

B !haotic interpersonal relationships! Sel=:inurious ehavior

D *anipulative ehavior

/9


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DBT Diar( Card $

/&


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Setting Personal 6oals 3 Maintaining Motivation

Be=ore e get into the core o= skills training; it is ise to egin y guring outhat your personal goals are in learning DBT skills< In other or>s; hat is itthat you hope to achieve ith the skills you learnP +our goals are uniHue toyou an> >eci>e> y you< *ost importantly; make sure that you set your goalsaccor>ing to hatyouant an> nee> not hat others say you shoul> antan> nee>< For those ho are in a stan>ar> DBT program; personal goals ten>

/(

ame8 Date8)o many >ays

>i> you ll in your

car>P0-7

Happy0-10

Sad0-10

Anger

0-10

Fear0-10

Shame

0-10

Guilt0-10

Target ProblemBehavior

UUrgeAA!tio

n

U or A"nten#i

ty0-$

S%ill&ulne##

'ating0-$

otes8

"un

Mon

#ues

Wed

#hurs

9ri

"at

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate3Stron 9Intense

Skill=ulness Rating8 Rate #rges 4:9

4 Di>nQt think aout using skills/ Thought aout skills; >i>nQt ant to usethem2 Though aoutante> to use skills ut>i>nQt7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul9 Di> not nee> skills; ut practice> them

#rge to Huit Skills Training

#rge to Huit In>ivi>ualTherapy

"ther #rges8

Week $ DBT Skills Tracking Table

Date8 Sun>ay *on>ay Tues>ay%e>nes>a

yThurs>a Fri>ay Satur>a

7oticed when % was in Wise Mind

7oticed when % was not in Wise Mind

7oticed when % was in $motion Mind

7oticed when % was in :ogica! Mind

#emerature

%ntense .h*sica! e0ertion

.aced ;reathing


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to relate to prolem ehaviors< I= you are not sure ho to gure out yourpersonal goals; DBT therapists ten> to use the =olloing hierarchy to targetehaviors in session accor>ing to their severity< +ou can use it to help youi>enti=y ehaviors you may ish to ork on hile you are in DBT skillstrainingestroy therapy7< Behaviors that aMect Huality o= li=e

Brainstorming Be'aviors I Want to C'ange

1 :ie #hreatening or


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SM.+T 6oals

S/eci7cMeaningful

.c'ievable+ecordable

Timeline8based

SP)CI9IC: Smart goals aremore specic than general< Aneample o= a general goal isgetting a o< To make thisgeneral goal more specic you

might a>> hat o ant toget an>; perhaps; >escriehat you nee> to get a oeep personal meaningto enhance motivation an>persistenceata or otheri>entiale means to trackprogress on S*ARTGoal

$ali>ate

Imagine

Take Small Steps

Achievale

Lighten +our Loa>

Seeten the 'ot

& Levels o=$ali>ation


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Core Mindfulness Skills

Mindfulness is a quality of attention & awareness to the present.

Watch the DBT Peer Connections Mindfulness skills training video on YouTube at

http://youtu.be/J3pnmOucl_4

W#.T Skills

"serveObserving brings you into the present

"tes to o+ser'ing

9ocus on o+ser'ing one thing at a time

7otice the e0erience o o+ser'ing without descri+ing it

4ou can o+ser'e things inside o *ourse!

4ou can o+ser'e things outside *ourse!

2(

=hat %kills

What to do to 'e $indful

&ow %kills

&ow to 'e $indful


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"serve)'ser"ing 'rings you into the present

When a thought comes a!ong

>ust notice it, then

Return *our attention to o+ser'ing


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Do not add to or su+tract rom what *ou see

Do not make interretations !ike descri+ing urrowed +rows, ursed

!is as anger

'articipate

Participating is being present fully in whatever activity you are engaging in

#hrow *ourse! into an acti'it*

;ecome one with the acti'it*

:ose se!8consciousness in an acti'it*

2-


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#OW Skills

How ski!!s reer to How "ki!!s "etHow to


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>udging is a shorthand wa* to descri+e conse/uences

7$A5#%V$ = B+adB

.


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What gets in the wa* o +eing eecti'e@

1 Wanting to +e right

2 7ot wanting to make the eort

( 7ot ocusing on *our most imortant goa!s

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Mindfulness2 . Dail( Practice

To uil> mastery in min>=ulness; one egins y trying as manykin>s o= min>=ulness tasks as it takes to n> one that orks =or

you< %hen you n> one or a =e skills that speak to your isemin>; you ant to start incorporating your tasks into >ailypractice< A common min>=ulness task that many peers use in their>aily practice is oserving the reath min>=ully< This is a goo> skillto start ith ecause it can e >one anyhere an> it orks on thenervous system to encourage calming an>or relaation yoursel= a ise:min>e> task list =or practicingmin>=ulness< Descrie at least one task =or each o= the core min>=ulnessskills< Fill in your tasks elo; accor>ingly< Then >o your task< Finally; come

ack to your orksheet an> note any pleasant or unpleasant emotions;thoughts; or environmental inuences that you notice> hile you practice>your min>=ulness skills< I= the task you chose >i> not ork =or you; think o= a>iMerent task =or that skill; an> keep trying until you n> one that orks =oryou< I>eally >o at least one purpose=ul practice a >ayi> you lle>car>0-'

(ood0-10

Happy

SadAng

erFear

Shame

Guilt


UUrge

AA!tion

U or A"nten#it

y

S%ill&ulne##

'ating

otes8

"unda*

Monda*

#uesda*

Wednesda

*

#hursda*

9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal

Skill=ulness Rating Inter=ering #rges 4:9

4 Di>nQt think aout using skills

/ Thought aout skills; >i>nQt ant to usethem2 Though aoutante> to use skills ut

>i>nQt7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul

9 Di> not nee> skills; ut practice> them

#rge to Huit SkillsTraining


"ther8

7&

D;# "ki!!s #racking #a+!e

Starting Date8 Sun>ay Tues>ay %e>nes>a Thurs>ay Fri>ay Satur>ay

"serve

Descrie

'articipate

"ne:min>=ully

on:u>gmentally

EMectively

"ther8

"ther8


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+ealit( .cce/tance Skills

Watch the DBT Peer Connections Reality Acceptance skills training video on

YouTube at http://youtu.be/LQmo3khTgRY

=hen are "eality Acceptance %kills useful@

When ainu! e'ents haen and *ou cannot change them, so!'e them, or make them go awa*

+adical .cce/tance

"adical Acceptance is accepting that

1 Rea!it* is what it is

2 $'er*thing has a cause

( :ie can +e worth !i'ing e'en when there is ain

"ememer

X .ain 7on85ccetance = "uering

X %t is eas* to accet things *ou !ikeX %t is hard to accet things *ou hate, disaro'e o , or that cause *ou a !ot o ain

X #he higher the ain, the harder the accetanceX % *ou want things to change, accet them, then change themX Rea!it* is a!wa*s changing and i *ou want to in!uence how it changes, *ou must

irst accet it

Turn t'e Mind

=hat is Turning the !ind@

%t is !ike wa!king down a road and coming to a ork where one road is acceting andone road is reecting and choosing to turn toward the acceting road o'er and o'eragain

%teps to Turning the !ind

7otice anger, +itterness, anno*ance, a!!ing into the sea o IWh* me@J & when *ou are

$scaing rea!it*

;!ocking things out Hiding how *ou ee!

2 Make an inner commitment to turn *our mind toward accetance

7(
http://youtu.be/LQmo3khTgRYhttp://youtu.be/LQmo3khTgRY


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( .ractice turning *our mind toward accetance o'er and o'er again

7,


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Willingness

=illingness is

X 5!!owing the wor!d to +e as it isX 5greeing to articiate in the wor!d as it isK 5cti'e!* articiating in rea!it*

K What *ou need to o'ercome a threat

Willfulness

=illfulness is

X "a*ing 7


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7oticeand o+ser'e Willfulness

.ractice Willingness+* articiating in rea!it*

5dot a Willing *osture oen hands, arms, ha!8smi!eE

Remem+er A##eptan#e is Diffi#ult and re/uires much time & ractice to +e

eecti'e

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+adical .cce/tance

Radical acceptance is about accepting reality or allowing the world to be just as it is.

This is a simple idea but a very hard concept to put into practice. Although we may wish

to radically accept our deepest, most painful experiences, it is more wise to start with

small tasks that are easier for you to accept like missing your favorite TV show last night

as opposed to your traumatic childhood. The easier the task is, the more like you are to

have success and the more success you have, the more likely you are to use the skill

again and build mastery. Above all, remember we do not achieve radical acceptance; we

practice radial acceptance.

Practice Ti/s for +adical .cce/tance

/< 'ain on:acceptance SuMering2< "serve i= you are Huestioning or ghting reality ith statements like;

It is not =air not e this ay yoursel= that =or etter or orse reality is hat it is >o i=you >i> accept the =acts< Then act as i= you have alrea>y accepte> the=acts< Engage in the ehaviors< That you oul> >o i= you really ha>accente> ith events that seem unacceptale< Imagine elievinghat you >o not ant to accept< Rehearse in your min> hatyou oul> >o i= you accepte> hat seems unacceptale to o>y sensations as you think aout hat you nee> to acceptisappointment< Sa>ness< "r grie= to arise ithin youge that li=e can e orth living even hen there is pain


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+adical .cce/tance Works'eet

INSTRUCTIONS:

For this homework task, you are going to pick something that causes you distress. It can

be a situation, an idea, a place, anything that exists that causes you pain. Try to pick

something that is on low end of distress since we want to start small. For example, you

might practice accepting that its a cloudy day or that you have to wait in line at a store.

Try to pick something that you are likely to have success with. Once you have chosen

your acceptance topic, answer question 1 and review the rest of the questions so you

know what to pay attention to while engaged in the practice. When you have completed

your acceptance task. (How long you practice is up to you. Then record your experience

using the worksheet as your guide.

1.On a scale from 0-100, what is my level of acceptanceBEFOREpracticing

Radical Acceptance?

2.Create a Radical Acceptance mantra that you can say to yourself that helps you

turn toward acceptance. For example, you might say. The only way to let go of

suffering is to accept suffering. or I dont like it, but it is what it is. or Pain +

Non-acceptance = Suffering.

3.What Problem thoughts came up if any?

4.What body sensations did I notice while practicing radical acceptance?

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5.What emotions did I notice within myself as I practiced Radical Acceptance?

6.If you have a hard time practicing Radical Acceptance, what do you think got in

the way?

7.On a scale from 0-100, what was my level of acceptanceAFTERpracticing

Radical Acceptance?

8. My deepest thoughts, feelings, or other comments I want to share about the

homework.

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+ealit( .cce/tance Skills 4ui5

1. The higher the pain a situation causes, the harder it is to radically accept thesituation.

a. True

b. False

2. Once you accept something, you will always accept it from that day forward.

a< True

< False

3. Practice _________________. Notice ________

a. %ill=ulness; illingness

b. %illingness; ill=ulness

c. %ill=ulness; ill=ulness

d. %illingness; illingness

. Pain ! non"acceptance # _____________

a. Distress

b. SuMering

c. Bor>erline personality >isor>er

d. Ra>ical acceptance

$. %adical acceptance and forgi&eness are the same thing

a. True

b. False

1. Turning the mind is li'e coming to a for' in the road where one side of the road is

acceptance and the other is non"acceptance and choosing to turn your mindtoward acceptance o&er and again.

c< True

>< False

1. (hich of the following is not a reality acceptance s'ill)

a< %illingness

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< Turn the *in>

c< Ra>ical Forgiveness

>< otice %ill=ulness

*. (hen starting out with radical acceptance it is wise to start with _____________

a. The things you ant to accept the most

b. Things that others ant you to accept

c. Easier things to accept

d. )ar>er things to accept

1. The __________________ the pain, the __________________ the acceptance.

a. )igher; easierb. Loer; har>er

c. Loer; higher

d. )igher; har>er

1. +ou must first accept a problem before you can begin to sol&e it

a. True

b. False

Anser Key8 /:a 2: 7: 3: 9: &:c (:c ,:c -:> /4:a

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Mindfulness to Willingness 3 Willfulness Works'eet

Radica! accetance sounds eas*, +ut accetance in itse! is not a erect state #hereore,

accetance is not a means to an end, +ut rather a ractice that we must continue throughout our

!ie


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,oving ;indnessLoving:kin>ness is a reality acceptance skill that e use to acknole>gereality hile cultivating uncon>itional compassion< In practicing loving:kin>ness; e consciously an> intentionally sen> arm ishes to ourselvesan>or others using a personal chant; script; or >ialogue that e say alou> orinternally as e practice Huiet min>=ul reathing< 'racticing loving:kin>nessreHuires us to e in ise min>< As e =ocus on the target o= our ell ishes;e let go o u>gments; epectations; an> >esires=ulness eercise; e ill start ith loving:kin>ness ysen>ing it to ourselves< "nce you ecome to =eel more com=ortale using theskill; you can a>> others to your loving kin>ness practice< The key is to startith people that you elieve it ill e easy to sen> ell ishes to an> orkyour ay up to those that it may e har>er to sen> ell ishes< Also; I= youn> it too >iOcult to start ith yoursel=; you may egin ith a pet; your chil>;or anyone else that your ise min> suggests in a com=ortale position ith your =eet plante> at on theoor

2< 'lace your right han> over your heart ith the palm open; presse>gently on your chest

7< Fin> a single place to =ocus your gaCe; usually looking =orar> an>slightly >onar>

3< Take a =e >eep; slo; stea>y reaths in an> out through your nose

9< Focus on your reath to ring you into ise min> or to yoursel= Huietly as youreathe >eeply an> min>=ully =or 7:9 minutes or as long as your in> min>suggests

(ay I be happy # (ay I be healthy # (ay I have peace

(ay I be loved # (ay I )now )indness # (ay I love and be )ind tomyself

A=ter you nish; on a scale =rom /:/44; please rate your>istress level

3,


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Diar( Card Week >

ame8 Date8 W o= Days >i> you lle>car>0-'

(ood0-10

Happy

SadAng

erFear

Shame

Guilt


UUrge

AA!tion

U or A"nten#it

y

S%ill&ulne##

'ating

otes8

"unda*

Monda*

#uesda*

Wednesda

*

#hursda*

9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal



/ Thought aout skills; >i>nQt ant to usethem2 Though aoutante> to use skills ut

>i>nQt7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul




"ther8

ISTR#!TI"S8 Fill in the name o= the month< Then eneath each eek>ay; ll in the >ateay *on>ay Tues>a %e>nes>ay

Thurs>a Fri>ay Satur>a

Radica! 5cce tance

#urn #he Mind

.ractice Wi!!in ness

7otice Wi!!u!ness

3-


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:o'in ?indness

94


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Distress Tolerance Skills Overview

9/

Watch the DBT Peer Connections Distress Tolerance skills training video on

YouTube at http://youtu.be/pkzpXrYXdKQ

;): POI1TS

What is the function of distress tolerance skills?

To help you get through a crisis ithout making it orse eMectively

Introduction

n >ialectical ehavior therapy ?DBT@ skills training; the ultimate goal is tolearn an array o= use=ul skills an> apply them to prolems in or>er to gureout hat skills ork est =or you< Through this process; over time; you illcome to replace prolematic emotional responses ith more eMective ones;re>uce emotional suMering; an> hope=ully increase your capacity toeperience oyuate> process o=steps that procee>s =rom one mo>ule to the net smoothly; the real course o=change; hen it comes to automatic emotional responses; is >iOcult;ongoing; an> certainly not a straight line< First; e all have >iMerent styles o=learning< A>> to that the uniHue circumstances o= our environments; hichinclu>e varying =actors o= social support; stressors; an> our aility to controlstressors; an> you can see hy uil>ing skills mastery is not sostraight=orar>aily commitmentto making steps toar> personal goals an> hen there are situations thatcause you to step ack an>; perhaps; not use skills or act on urges to >oprolematic ehaviors; you get ack into ise min> an> commitment to yourDBT path as Huick as possile so that you continue to make progress< Thiscare=ul alancing act o= >etermination toar> change an> acceptance o=onesel= =or ehavioral slips is calle> >ialectical astinence< In practicing>ialectical astinence; ST"' skills are a use=ul set o= skills that aim to helpyou re>irect your attention an> action hen you n> you are ecomingemotionally >ysregulate> an>or have a slip in target ehavior a personaliCe> ST"' skills plan; rst you ant to i>enti=y=actors that you can recogniCe in the moment that signal to you that you areeither getting close to or are outsi>e your in>o o= tolerance; hich is thepoint here you ecome so emotionally >ysregulate> you regress into pastpatterns o= prolematic responses< These =actors comine> >ene your s)illsbrea) down point. I>enti=ying =actors ?o=ten calle> triggers@ can e actions;

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o>y sensations; cognitions YthoughtsZ; events; an> =eelings; or&!"*+; =orshort . o>y aay=rom multi:tasking to atten> to every >etail o= hatever process you are>oing

*acation

atch your =avorite T$ shoN Go to the park . lounge in the grass an>orturn oM your phone =or a >ayN Go camping =or the eeken>N take a nap ith aso=t lanket

)ncouragement

!heerlea> yoursel= ith statements like;

5I can get through thisoing the est I can


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IMP+O*) Skills Works'eet

ame8 Date8 Therapist8

%n the o!!owing chart i!! in %M.R


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&/


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Sel=:soothe ith the Senses %orksheet

Sig't

%atch the sun rise or setN got to a local art shoingN get your nails >oneN

light a can>leN get a novelty light

"ther8

Sound

Listen to soothing music or nature soun>sN sing your =avorite songN play or

learn to play an instrumentN >onloa> a min>=ulness ell app =or your

smartphone

"ther8

Taste

suck on a piece o= har> can>yN che your =avorite avor o= gumN uy

yoursel= a small gourmet treat< sip a cup o= hot chocolate or ice> mocha;

sloly

"ther8

Touc'

'et your >og or catN hug someoneN take a ule athN have a massage

"ther8

Smell

Light a scente> can>le; incense; ear your =avorite per=ume or cologne

get some =resh oers =or home"ther8

&2


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Make a Self8soot'e ;it #omework

Fin> a small asket; purse; o; etc< an> ithin it place at least one soothing

item per sense ?sight; soun>; Taste; Touch; Smell@< Keep it in a convenient

place here you can Huickly get to it in a crisisi> you lle> car>0-'

(ood0-10

Happy

SadAng

erFear

Shame

Guilt

TargetBehavior

UUrgeAA!tion

U or A"nten#

ity

S%ill&ulne##

'ating

otes8

"unda*

Monda*

#uesda*

Wednesda*

#hursda*

9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate3Stron 9Intense



/ Thought aout skills; >i>nQt ant to usethem2 Though aoutante> to use skills ut>i>nQt7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul



#rge to Huit In>ivi>ual Therapy

"ther8

*BT %kills Tracking TaleStarting Date8 Sun>ay *on>ay Tues>ay %e>nes>ay Thurs>ay Fri>ay Satur>ay

&3


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&9


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)motion +egulation Skills

Identif(ing ,abeling 3 9unctions of )motions

Watch the DBT Peer Connections Introduction to Emotion Regulation skillstraining video on YouTube at http://youtu.be/RkP5dCowv90

M(t's about )motions #omework

I1ST+0CTIO1S2 or each myth about emotions, thin' of and write in an opposingstatement thatchallenges the myth. The idea is to build awareness to myths and newdialectical perspecti&es.

/< I =eel this ay =or no reason a = un ct io n not pay attention to pain=ul emotionsoramaes a list o= emotions an> =actors to help you>etermine hether an emotional response an>or its level o= intensity isappropriate an> ts the =acts oi= a prolematic situation o= >oing over an> over again

5nger T'e O//osite .ction for0nGusti7ed .ngeris2

Gently A$"ID person you are angry ith ?rather than

Disgust

T'e O//osite .ction for 0nGusti7ed Disgustis2

*"$E !L"SE< Eat; >rink; stan> near; or emrace hat you

=oun> >isgustingestroying hat the other person has

Do the "''"SITE o= envious action urges

!"#T +"#R BLESSIGS

>ea!ous* T'e O//osite .ction for 0nGusti7edealous(is2

LET G" o= controlling others actions

S)ARE hat an> ho you have in your li=e

:o'e T'e O//osite .ction for 0nGusti7ed ,ove is2

A$"ID the person; animal or oect you love

((
http://youtu.be/hmvDk-zUcMYhttp://youtu.be/hmvDk-zUcMY


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"pposite to Emotion Action

Use o''osite action when your e#otion does not %t thefacts

Watch the DBT Peer Connections Opposite Action training video on YouTube at

http://youtu.be/hmvDk-zUcMY

"adness

T'e O//osite .ction for Sadnessis2

Get A!TI$EN approach; >o not avoi>ically Accet the Emotion

: Act on Emotion;

: *in>=ulness to !urrentEmotion

: Accept !onseHuences

Grace=ully

1O

Secon>ary Emotion

Solutions

: Ra>ically Accet the Emotion

: !hange Thoughts to Fit Facts

: "pposite Action

: 'rolem Solve

Working wit' Primar( 3 Secondar( )motions

7ame Date #heraist

The easiest ay to gure out hether you are eperiencing a primary orsecon>ary emotion is see hether the emotion ts the =acts an> that it isappropriate in level o= intensity< I= your emotion ts the =acts it is usually aprimary emotion; i= it >oes not t the =acts it is usually a secon>ary emotion secon>ary emotionsary emotion ?>oesnQt t the=acts@P

Primar( )motion Secondar( )motion

%hat solution >i> I use =or my emotion an> hat as or as not help=ulaout itP

,/


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Diar( Card Week @

1ame2 Date2 )o many >ays >i> ll car>P0-7

Mood0-10

Happy

Sad

Anger

Fear

Shame

Guilt


UUrge

AA!tion

U or A"nten#

ity

S$ill%ulne##

&ating

1otes2

%unday

!onday

Tuesday

=ednesday

Thursday

,riday

%aturday

Indicate Target Behavior with U for Urge or A for Action. Rate the intensity level as:

Skillfulness +ating +ate Interfering 0rges

&8"4 Di>nQt think aout using skills/ Thought aout skills; >i>nQt ant touse them2 Though aoutante> to use skillsut >i>nQt

7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul9 Di> not nee> skills; ut practice>them

#rge to Huit SkillsTraining#rge to HuitIn>ivi>ual"ther8

DBT Skills Training Tracking Tale

Skill PracticedSunda

(Monda

(Tuesda

(Wednes

da(T'ursd

a(9rida(

Saturda(

5cted oosite to 5nger

5cted oosite to 9ear5cted oosite to "adness

5cted oosite to "hame

5cted oosite to Aui!t

5cted oosite to >ea!ous*

5cted oosite to 5nger


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Be'avior C'ain .nal(sis 3 Solutions

7ame Date #heraist

%7"#R-C#%


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Describing ,inks 3 6enerating Skills Solutions

ISTR#!TI"S8 In the le=t column; enter the letter representing hat type o=

link the ehavior is in the chain ?See eloescrie the link ehavior in >etail< Belo each link >escription; rite in a skill

you coul> use in place o= the prolematic ehavior< Repeat the process =or

each link in the chainnQt think aout using skills 7 #se> skills; ut they >i>nQt help Intensit( of 0rges &8"

/ Thought aout skills; >i>nQt ant 3 #se> skills . they ere help=ul #rge to Huit Skills

2 Though aoutante> to useskills ut >i>nQt

9 Di> not nee> skills; utpractice> them

#rge to Avoi>)omeork

ISTR#!TI"S8 Fill in the name o= the month< Then eneath each eek>ay; ll in the >ateay that you practice> a liste> skillay *on>ay

Tues>a

y

%e>nes>ay

Thurs>ay

Fri>ay Satur>ay

.ro+!em "o!'ing

;eha'ior Chain 5na!*sis

Aenerated "o!utions

5!ied "o!utions

,-


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.BC P,).S) Skills

1atch the corresponding -)ills Training 5ideo

on 6ouTube at the following 2in)

http8youtu


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Let go o= epectations aout the pleasant eperience

Buil> *astery Do at least one thing each >ay to uil> a sense o= accomplishment

'lan toar> success over =ailure

Do something >iOcult; ut achievale

Gra>ually increase the >iOculty over time

I= the rst task is too >iOcult; >o something easier

-/


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Cope Ahea> o= Time =or Emotional Events I>enti=y a situation that is likely to cause overhelming emotions

Deci>e hat skills you ant to use in the situation

Imagine yoursel= coping eMectively in the situation right no Rehearse coping eMectively y role playing ith therapist=rien>peer

Rehearse ith ne prolems that may come up

P,).S) Skills

treatPhysical I,lness

)at Balance> *eals.voi> >rug misuseSleep Balance>

)ercise Regularly

Treat 'hysical Illness

Take care o= you physical health

See a >octor hen nee>e>

Take me>ications accor>ingly

Rememer that eing ill causes increase> emotional vulneraility

Eat alance> *eals

Do not eat too much or too little

Eat regularly an> min>=ully Stay aay =rom =oo>s that aMect emotionality

Eat =oo> that have omega:7 =atty aci>s

See a nutritionist i= necessary

Avoi> *oo> Altering Drugs

Stay oM illicit >rugs

Stay aay =rom alcohol

use me>ications as or>ere> y prescrier

Sleep Balance> Figure out ho much sleep you nee> a night to =eel reste>

Sleep accor>ing to a consistent sche>ule\I= you have sleep >iOculties;plan a sleep sche>ule . stick to it

Eercise Regularly

Eercise at least a little every >ay

-2


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Try to uil> up to 24:74 minutes o= >aily eercise

!onsult your >octor i= you have any special health consi>erations

-7


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.BC P,).S) #omework

/ 'leasant Thing A Day %eekly %orksheet

"unda*

Monda*

#uesda*

Wednesda*

#hursda*

9rida*

"aturda*

/ Skill a Day to Buil> *astery %eekly %orksheet

Monda*

#uesda*

Wednesda*

#hursda*

9rida*

"aturda*

Monda*

*y 'LEASE Skills Daily Routine %orksheet#reat %!!ness What #an do daily to ensure treat or pre"ent illness%

$at ;a!ancedMea!s

&ow $any Meals a daywill ha"e%

&ow $any sna#ks aday will ha"e%

What ti$es a day will eat%

7otes

5'oid Drugs &ow will $ake sure to a"oid drug $isuse%

-3


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"!ee ;a!anced What ti$e will get up ea#h day% What ti$e will go to 'ed ,a#h

Day%

$0ercise &ow $any ti$es a week will exer#ise! for how long! and doing

what%

-9


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Diar( Card Week $&

1ame2 Date2 #ow man( da(s did (ou 7ll incardH0-7

Mood0-10

Happy

SadAnger

FearShame

Guilt

Target

Behavior

UUr

geAA!t

ion

U or A"nten#ity

S$ill%ulne##

&ating

1otes2

%unday

!onday

Tuesday

=ednesda

y

Thursday

,riday

%aturday

Indicate Target Behavior with U for Urge or A for Action. Rate the intensity level as:

Skillfulness +ating +ate Interfering 0rges

&8"4 Di>nQt think aout using skills/ Thought aout skills; >i>nQt ant touse them2 Though aoutante> to use skillsut >i>nQt

7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul9 Di> not nee> skills; ut practice>them


#rge to Huit Therapy

"ther8

Starting Date8 Sun>ay *on>ay Tues>ay %e>nes>ay

Thurs>a Fri>ay Satur>a

Accumulate 'ositive Ep< Sleep Balance>

Buil> *astery Eercise

!ope Ahea> o= Time

Treat 'hysical Illness

Eat Balance> *eals

Avoi> *isusing Drugs

-&


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Inter/ersonal )Eectiveness Skills

Interpersonal ffectieness %killsare a road ma or getting what *ou want through eecti'e

communication and ma* +e +etter remem+ered +* the acron*ms *A"; !A$; +I); ,A%T


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.ssert

%hen communicating; it is essential to state eactly; clearly; an> as simply

as possile hat it is you ant< For eample; instea> o= saying; 5The rule is

not =airo thisUUUUUUUU non:u>gmental to oMer reasons that support your point o= vie an>or reHuest calm >emeanor hen the situation is tense< The more

calm attentiveness you sho to others; the more likely they ill e

com=ortale; receptive; an> illing to communicate ith you oective in your conclusions< I= you are going to criticiCe another;

make sure your opinions arrive y atten>ing to alancing =acts rather than

relying on personal pre=erence or emotions< Even i= you =eel strongly; resist

the urge to regar> your =eelings or point o= vie as more important< !onsi>er

other peopleQs nee>s an> ants in a>>ition to your on< Strive =or reciprocity

in relationships; that is eHually giving an> receiving in relationshipser the =olloing statement< 5I am sorry; ut I have to >isagree ith

youescrie; epress; an> assert yoursel= appropriately an>

accor>ing to your personal values; unnecessarily apologiCing simply ecause

your point o= vie may not match that o= those ith hom you are

communicating only serves to eaken the appearance o= sincerity hen a

true apology is arrante> morals are an> >o not

compromise them =or the sake o= avoi>ing conict or appeasing others; respect others values; an> hen it

comes that you =eel the nee> to Huestion values; stick to your on as they

are the only ones you are empoere> to manageone in or>er to the prolem8

+einforce; state the enets o= =ullling your reHuest

/47

ndful/;e mindu! o en'ironmenta! 'u!nera+i!ities, *ours & others emotions Choose words

eu!!*

pear confident/-se direct e*e contact head high, shou!ders +ack, arms uncrossed, a!ms

n

egotiate2Be illing to compromise i= there is unillingness to meet theecics o= your reHuest


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Instructions2 %se this wor)sheet to create a plan for e8ectively re9uestingsomething you want or need from someone where the situation is uncertain,emotionally arousing, and:or susceptible to con;ict.

*A" !A$ +I) ,A%T =orksheet HContinued

+entle Descri+e wa*s *ou can communicate gent!*

Interested How can *ou show the other erson *ou are interested in what he6she sa*s@

)alidateHow can *ou 'a!idate others emotions@

asy !anner Descri+e wa*s *ou can communicate with an eas* manner

,air/ What is air to *ou in this situation

Apology ,ree/ Descri+e what *our urge to ao!ogize might +e in this situation

/43


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%tick to )alues/What are *our 'a!ues in this situation@

Trut'ful2%hat are the =acts you nee> to stick toP

/49


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Diar( Card Week $$

ame8 Date8 )o many >ays >i> you llcar>P

Mood

0-10

Happy

Sad Anger FearSham

e Guilt

Target Behavior UUrg

eor

AA!tion

U or A"nten#it

y0-$

S%ill&ulne

##'ating

0-$

otes8

%un

!on

Tues

=ed

Thurs

,ri

%at

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate3Strong 9Intense

Skill=ulness Rating Rate Inter=ering #rges 4:9

4 Di>nQt think aout using skills/ Thought aout skills; >i>nQt ant touse them2 Though aoutante> to use skills ut

>i>nQt7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul9 Di> not nee> skills; ut practice>them



"ther #rges8

*BT %kills Tracking Tale

ISTR#!TI"S8 Fill in the name o= the month< Then eneath each eek>ay; ll in the >ate< Fillin the rst letter =or the skill you practice> the o =or each >ay that you practice>< Eample D

Starting Date8Sun>ay *on>ay Tues>ay %e>nes>ayThurs>a

yFri>ay Satur>ay

Descrie GentleEpress Intereste>

Assert $ali>ate

Rein=orce Easy *anner

*in>=ul Fair

Appear Apology Free

/4&


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egotiate Stick to $alues

Truth=ulness

/4(


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Course +eview

/4,


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Personal Peer )m/owerment Plan

/4-


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Diar( Card Week $

ame8 Date8 Days you ll in the car>P0-7

(ood

0-10

Happ

y

SadAnge

r

FearSham

e

Guilt

Target Behavior UUrge

AA!tion

U or A"nten#it

y

S%ill&ulne##

'ating

otes8

"unda*

Monda*

#uesda*

Wednesda*

#hursda*

9rida*

"aturda*

Indicate Target !ehavior with % for %rge or & for &ction. $ate the intensity level as' /*inimal 2*il> 7*o>erate 3Strong

9Intense

Skill=ulness Rating Rate Inter=ering #rges 4:9

4 Di>nQt think aout using skills/ Thought aout skills; >i>nQt ant to use them2 Though aoutante> to use skills ut >i>nQt7 #se> skills; ut they >i>nQt help3 #se> skills . they ere help=ul9 Di> not nee> skills; ut practice> them



"ther8

Starting Date8 Sun>ay *on>ay Tues>ay %e>nes>ay Thurs>ay Fri>ay Satur>ay

//4


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///


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DBT +esources

DBT Smart P'one .//s +eviews

http8ilove>ttapps

%ith the a>vent o= >igital in=ormation an> the orl>i>e e; the orl> o=psychotherapy an> society in general continues to look =or ne an> use=ulays to incorporate >igital technologies into our every>ay lives< )ere the=ocus is specic to smart phone applications ?An>roi>; i"S(; etcialectical ehavior therapy ?DBT@ate; a variety o= sai> applications can e >onloa>e> =ree an>or =or amo>est price on the market ?either y e; iTunes; an>or Google 'lay@ an>

ne ones are certainly on the ay< Each app presente> an>>iscusse> elo inclu>es >onloa> links; >eveloperQs summariCe>>escriptions veratim; an> my personal revie notes =olloing ?highlighte>in re>; ol> type@e a general overvie o= availale applications ithuser notes an> is provi>e> purely =or your re=erence< #serQs are in=orme> touse the liste> applications at their on >iscretion an> are aare that thein=ormation provi>e> herein >oes not mean to replace therapy provi>e> yHualie> mental health pro=essionalser

O/timism

9+)) KWindows Mac OSL iP'one Web

"ptimism apps are sel=:tracking applications; >esigne> to help you increaseyour un>erstan>ing o= all the things that aMect your mental health< Theapps act as a springoar> to >etect patterns in your health an> >evelop

//2
http://ilovedbt.com/2014/03/27/dbtapps/mailto:[email protected]?subject=DBT%20Peer%20Connections%20Website%20Commentshttp://www.findingoptimism.com/http://ilovedbt.com/2014/03/27/dbtapps/mailto:[email protected]?subject=DBT%20Peer%20Connections%20Website%20Commentshttp://www.findingoptimism.com/


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strategies to proactively manage >epression; ipolar >isor>er; an> othermental health con>itions an> skills tracking >igitally inthat it provi>es synchroniCation across >evices an> the e; oMersgraphical inter=ace =or vieing skillstarget ehaviors over time ?Figes a customiCale remin>er =unction; an> has clinicianmanagement option to allo =or collaoration an>or sharing reports ?Fig< !@that may e sent to sel=; therapist; etc< accor>ing to user pre=erence< In mycase; I have a eekly report sent at (pm the night e=ore my in>ivi>ualsession to my therapist so she may have my >iary car> on han> e=ore Iarrive =ort'era/(!

//7


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OPTIMISM SO9TW.+) DBT DI.+: C.+D S)T0PI1ST+0CTIO1S2

#owever t'ere is a catc' to using t'is software as a diar( card!T'e interface must be manuall( con7gured wit' DBT s/eci7c dataelements /rovided and arranged according to (our own/reference! T'is took me some time to 7gure out t'roug' trial anderror! I contacted t'e develo/er about creating a function forsavingNdistributing user tem/lates w'ic' ma( be included infuture u/dates! T'is software is recommended for advancedcom/uterNmobile a//lication users! #owever t'e good news is t'atall m( 'ard work is summed u/ in t'e screens'ot below! K9ig! .w'ic' will surel( cut (our set u/ time to a minimum!

/ Go to'tt/s2NNwww!o/timismonline!comNregister!/'/an> registerith the esite< This allos you to ll in your >iary car>; receiveremin>er notications; an> synchroniCe your >ata across >evices< Foreample; I can ll in my car> on my computer; synchroniCe >ata; thenopen the app on my i'hone an> the >ata I entere> through my computerill sho up on my i'honei'a>< ?An>roi> version is un>er >evelopment;accor>ing to the >eveloper 'ASS%"RD thatyou create> hen registering ith the "ptimism So=tare esite< ?See

//3
https://www.optimismonline.com/register.phphttp://www.findingoptimism.com/https://www.optimismonline.com/register.phphttp://www.findingoptimism.com/


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step /@es >etaile> in=ormationon the eMects o= stress on the o>y an> instructions an> practice eercisesto help users learn the stress management skill calle> >iaphragmaticreathing< Breathing eercises have een >ocumente> to >ecrease the

o>yQs _ght:or:ightQ ?stress@ response; an> help ith moo> stailiCation;anger control; an> aniety management< Breathe2Rela can e use> as astan>:alone stress re>uction tool; or can e use> in tan>em ith clinicalcare >irecte> y a healthcare orker

1ote2 T'is is a must 'ave 9+)) mobile a// for an(one wit' asmart/'one w'o wants to 'el/ manage t'eir stress! .s a DBTrelated a// t'is software will 'el/ (ou build mindfulness to breat'b( /roviding (ou guided breat'ing instruction wit' visual gra/'icsand audio t'at (ou can customi5e to t'e second according to (ourown in'aleNe'ale c(cle! T'is a// is 'ig'l( recommended for t'ose

wit' aniet( Panic andNor PTSD related s(m/toms

//(
https://play.google.com/store/apps/details?id=org.t2health.breathe2relaxhttps://play.google.com/store/apps/details?id=org.t2health.breathe2relax


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Bowls .ut'entic Tibetan Singing Bowls

9+)) KiP'one Onl(

Sirl your ngers sloly aroun> the e>ges o= the ols to create eauti=ulme>itative harmonic tones< Tap the ols; gongs; ells; an> tingshacymals to a>> >epth an> variety to your music< E% Feature] Recor> an>save your masterpieces an> play them ack hile relaing or me>itating toring peace to your min>; o>y an> soul< #se this app =or me>itation;music; relaation; an> personal ell:eingically >uring the >ay; to give youthe opportunity to hol> on =or a moment an> consi>er hat you arecurrently >oing; an> in hat state o= min> you are hile you are >oing iting to the 1en Bu>>hist teacher Thich hat )anh; this is an eMectivemeans o= >eveloping min>=ulness improve your relationshipsith DBT Revie; a personal:use DBT tool< This app as >esigne> as alearning a>unct =or people learning DBT or orking ith a DBT therapist< The app is ase> on *arshaLinehanQs 5!ognitive:Behavioral Treatment =or Bor>erline 'ersonalityDisor>er6 ?/--7@< This app is not recommen>e> =or anyone un=amiliar ithDBT skills an> is not a sustitute =or therapyiary o= your >aily urges;emotions an> skills use>< "ne o= the challenges o= keeping a >iary it is easyto =orget the eact >etails o= events hen you are lling out your >iary atnight or e=ore a therapy session< The DBT Diary app solves this prolem y

helping you keep a >etaile>; accurate >iary throughout the >ay; at theeact time o= each event; herever you are; y using your moile >evice has to oMer V Skills

Documents

Dialectical Behavior Therapy Skills Training Workbook3