Dialectical Behaviour Therapy: The Clinical Framework


In this talk, Dr. Ella Brent introduces the clinical framework of Dialectical Behaviour Therapy (DBT). Dr. Brent defines the 'dialectic' between acceptance and change which is important in work with clients struggling with self-harm and suicidal behaviours, and then moves on to outlining a hierarchy of aims to be addressed with this population, from addressing imminent suicide risk, to reducing self-harm, to developing skills for more rewarding outcomes. Dr. Brent then offers a framework for conceptualising clients' difficulties, which can be used to structure the history taking and assessment process with clients who struggle with affect regulation and self-harm. This practically applicable framework captures distressing feelings, impulsive behaviours, relational difficulties, and experiences of emptiness, showing how these form a vicious cycle, maintaining clients' difficulties. This framework anchors the clinician faced with overwhelming material, allowing clinicians to help clients to make sense of these experiences.        


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