Bullying and the                                                                                What is Dialectical Behavior Therapy (DBT)?
                                  Emotional Mind: 
                             Teaching DBT Skills                                                                                    •  Another premise is clients need validating environments 
                                                                                                                                       in which they are taught to regulate emotions, deal with 
                             to Foster Resiliency                                                                                      interpersonal conflicts, tolerate distress, and find 
                                                                                                                                       balance in the lives.
                                                                                                                                    •  The goal of DBT is to teach healthy coping skills to help 
                                                                                                                                       clients manage intense emotions without the use of self-
                                                Kimberly L. Mason, Ph.D., LPC-S, NCC                                                   destructive behavior, with the ideal result being 
                                                                 LCA Conference                                                        improved relationships. 
                                                              September 27, 2016
                                                                  Objectives                                                         Biology and Emotion Regulation
                                                     Understand	DBT	and	Bullying	
                                                     Goodness	of	Fit
                                                         Learn	the	Foundation	of	DBT				
                                                        Develop	a	Bullying	Prevention	Model	
                                                        Based	on	DBT	Core	Skills			
                                                     Cultivate	DBT	Strategies	to	help	youth	
                                                     accept	their	feelings	and	to	use	thinking	to	
                                                     change	feelings	
                             What is Dialectical Behavior Therapy (DBT)?                                                                        Biology, the Amygdala, and  
                                                                                                                                                       Emotion Regulation
                              •  DBT is a cognitive-behavioral approach that emphasizes                                             •  Functional magnetic resonance imaging (fMRI) studies in 
                                 the psychosocial aspects of treatment.                                                                BPD show increased amygdala activity to specific types 
                                                                                                                                       of stimuli.
                              •  Premise of DBT is that individuals struggle to tolerate and                                            – “unresolved” life events, emotional faces, positive and 
                                 regulate strong emotional states.                                                                         negative emotional pictures, and emotionally-triggering 
                              •  Emotional dysregulation (affective instability) is caused by:                                             scripts.
                                  1. heightened emotional responsivity                                                              •  DBT targets amygdala hyperactivity
                                     •    high sensitivity to emotional stimuli and heightened emotional                                – part of the disturbed neural circuitry underlying emotional 
                                          intensity                                                                                        dysregulation.  
                                  2. difficulties in effortful modulation of negative affect. 
                                                                                                                                                                                         (Goodman et al., 2014)
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                             DBT	and	Bullying:	Goodness	of	Fit                                                            DBT	and	Bullying:	Goodness	of	Fit
                            •  Adverse childhood experiences in combination with                                              Given that DBT has been shown 
                               biological vulnerabilities and heightened emotional 
                               and behavioral dysregulation are thought to be                                                   effective in treating emotional 
                               relevant in the etiology of bullying, BPD, depression,                                        regulation, DBT-ST  can help youth 
                               anxiety, and self-harm (Linehan, 1993).
                                                                                                                            reduce emotional dysregulation and 
                            •  Research indicated in children under 12 who were                                              reactivity by addressing deficits in 
                               bullied, there is an increased risk of developing poor                                      emotion regulation, distress tolerance, 
                               mood and impulse control, unstable and intense 
                               personal relationships, and severe difficulty trusting                                        and interpersonal relationships so 
                               the actions or motives of others (Wolke et al., 2012).                                                bullying may decline. 
                             DBT	and	Bullying:	Goodness	of	Fit                                                            Foundation of DBT
                          Emotions can facilitate or impede youths’ peer relationships                                              • Dialectics
                                                                                                                                    • Behaviorism
                             •  Youth who engage in bullying have lower competence                                        Paradigms • Mindfulness
                                in managing their emotions, being empathetic, solving                                               • Wholeness and Interrelatedness
                                problems, and/or evaluating the consequences of their                                     Dialectical  • Polarity
                                actions.                                                                                   Principles  • Continuous Change
                             •  Victims of bullying experience fear, isolation, anxiety,                                            • Reducing dysfunctional behaviors
                                anger, hurt, and embarrassment. They have increase                                                  • Increasing skillful behaviors
                                in health concerns and withdraw activities they once                                       Purpose  • Building a life worth living
                                enjoyed. 
                             DBT	and	Bullying:	Goodness	of	Fit                                                                              Foundation of DBT
                                                                                                                                               Dialectical View
                                                                                                                                          Opposites can co-exist
                            •  Current research shows that DBT has been shown effective in 
                               treating transdiagnostic disorders.                                                                                               •  A life worth living has 
                                                                                                                                                                    positive and negative 
                            •  Emerging evidence suggests that DBT skills training (DBT-ST)                                                                         aspects
                               reduces problems with emotions.                                                                                                   •  Find ways to accept 
                            •  DBT-ST has been shown to reduce emotion dysregulation,                                                                               BOTH sides of a 
                               increase skills use, and reduce anxiety severity for individuals                                                                     situation and find a 
                               who met criteria for BPD, depression, anxiety, eating                                                                                synthesis that does not 
                               disorders, self-harm, and suicidal ideation.                                                                                         negate the reality of 
                                                                                                                                                                    either.
                           (Harley, Sprich, Safren, Jacobo, & Fava, 2008; Linehan, 1993; 1994; Neacsiu, Rizvi, & Linehan, 2010; Neacsiu et al, 
                           2014; Soler et al., 2009; Safer, Robinson, & Jo, 2010)
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                                                   Foundation of DBT                                                                 Balanced Thinking
                                            Teen Dialectics Examples
                               •  There is no absolute truth; everyone has something to                                               •  Avoids all or none and accepts “both”
                                  offer.                                                                                              •  Acceptance and hope 
                               •  I am doing the best I can and I can do better.                                                          – (Parents often feel that if they accept they give up hope; this 
                                                                                                                                             dialectic needs to be re-enforced so they do not become 
                               •  I am tough and I am gentle. I may not have caused all of                                                   hopeless) 
                                  my problems, and I’m responsible for working on them.                                               •  Independence and assistance 
                               •  A life worth living has happiness, sadness, anger, and                                              •  Choices and limits 
                                  calm, and all of these things are valuable and necessary.                                           •  Giving in and choosing priorities 
                                                                                                                                      •  Firmness and gentleness 
                               Obstacles to Dialectical Thinking                                                                     Balanced Language
                                •  All Or Nothing: If you’re not perfect, you’re a total                                           Help kids use less extreme 
                                   loser.                                                                                          or absolute words 
                                •  Disqualifying the Positive: The good stuff doesn’t                                              •  Minimize use of always,                   the possibility of hope 
                                   count because the rest of your life is a miserable pile                                            never, everyone, nobody, 
                                   of crap.                                                                                           you make me 
                                •  Jumping to Conclusions: You suddenly become a                                                   •  Use “I feel…” statements,                 anger, disappointment,
                                   psychic mind reader and know exactly what everyone                                                 instead of “You are…”                            and frustration 
                                   really thinks.                                                                                     statements.
                                •  Emotional Reasoning: You start thinking emotions                                                •  Instead of saying: “Everyone 
                                   are facts. I feel like she hates me, so she does.                                                  always treats me unfairly,” 
                                                                                                                                      say “Sometimes I am treated 
                                                                                                                                      fairly AND at other times I am 
                                                                                                                                      treated unfairly.”
                               The Central Dialectic in DBT                                                                          Creating Balance
                                                                                                                                     •  As a counselor, you balance understanding your 
                                                                                                                                        clients’ behavior in the context of their life AND 
                                                                                                                                        helping them to learn skills to manage their behaviors 
                                                                                                                                        better. 
                                                                                                                                         – An emphasis either on acceptance or on change is usually 
                                                                                                                                            ineffective 
                                                                                      Problem Solving                                •  Validation means the acceptance that someone is 
                                 Mindfulness                                          Cognitive Behavioral                              doing the best he/she can in the context of his/her life 
                                 Radical Acceptance                                   Goals and Contingencies                           is as true for parents as for the adolescent. 
                                 Turning the Mind                                                                                    •  Validation communicates empathy and acceptance 
                                 Validation
                                                                                                                                        and serves to de-escalate emotional situations .
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                      Social Conformity Experiment                                                   Behaviorism Paradigm
                      Creating Balance                                                     A Bullying Prevention Model Based on 
                                                                                                          DBT Core Skills 
                       It is important to remember, and to remind your                                         Mindfulness
                       clients, that behaviors have been learned; they 
                                                                                               Interpersonal                    Distress 
                        can be unlearned and new behaviors can be                              Effectiveness   DBT             Tolerance
                                  learned to replace them. 
                                                                                                                Emotional 
                                                                                                                Regulation
                      DBT Balances
                       Skills Acquisition: teaching new behaviors                                Mindfulness
                                             VS.
                       Validating and Reinforcing existing adaptive                                    Focusing Skills
                                            behaviors
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