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picture1_Learning Pdf 109179 | Distress Tolerance Final Slide Handout


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File: Learning Pdf 109179 | Distress Tolerance Final Slide Handout
distress tolerance skills 10 9 2019 zoom housekeeping this call is being recorded dbt distress tolerance skills please be mindful to not share phi or information that could inadvertently identify ...

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     Distress Tolerance Skills                                                                                                                            10/9/2019
                                                                                            ZoomHousekeeping
                                                                                            • Thiscallisbeingrecorded
              DBTDistressToleranceSkills                                                • PleasebemindfultonotsharePHIorinformationthat
                                                                                               couldinadvertentlyidentifyapatient
                                                                                            • Mutewhennotspeaking
              AnnaHink,MSW,LICSW                                                         • Audio&videocontrolsinlowerleftcorner
              ClinicianTrainer                                                                    Mute/Unmute                      Chattechnicalissuesor
                                                                                                        VideoOn/Off                questionsanytime.
              UWAIMSCenter
            LearningObjectives                                                             WhatIsACrisis?
            Afterthistraining,participantsshouldbeable                                   Aseriousproblemthat      Thereispressuretosolve
            to:                                                                                can’tbesolvedrightnow       theproblem,anditis
                                                                                                                               difficulttostoptrying
            • Understandthepurposeofdistresstolerance                                                             Crisis
               skills
            • Recallwhendistresstoleranceskillscanbe                                    Emotionsarehigh,sothe          It’sshortͲterm
                                                                                                 problemisdistressing      Ifitishappeningallthetime,
               usefulforyourpatients                                                         Highemotionsgenerally      itisnotacrisis.Itisyourlife!
            • ListtheDistressToleranceskills                                                  makethingsworse
            3                                                                               4
                                                                                                                                                                1
      Distress Tolerance Skills                                                                                                                                                                          10/9/2019
                CanYouSolveTheCrisis?                                                                               Checkpoint:
                                       •   Stickwithit                                                                • Whatkindofcrisesdoourpatientsruninto
                  IfYes…              •   Don’ttakeyoureyeofftheball                                                 intheirlives?
                                       •   Dowhatittakes!
                    IfNo             •  STOPtryingtosolveit
                                      •  Tryingtosolvetheunsolvablecanmakeit
                (ornotright           worseorsendemotionsthroughtheroof
                    now)…            •  FocusonDistressTolerance skills         DTskillsare
                                                                                 designedjustfor
                                                                                 anunsolvedcrisis
                5
                WhatAreDistressToleranceSkills                                                                     GoalsOfDistressToleranceSkills
                For?                                                        Patients                                   • Helppeoplesurvivethecrisisandnotmaking
                                                                                face                                       thesituationworse
                •Cravingsandtriggers                                         many
                •Painflares                                                stressors                                   • Notintendedtoimprovefeelings(though
                •Frustrationswithmedical                                                                                 sometimesbeingmoreincontrolhelps)
                  care/socialservices                                                                                      •   Anescalatedcrisismaymakethingsworseandmake
                                                                                                                                peoplefeelworse
                •Intenseemotions                                                                                       • Increaseconfidenceinmanagingfuturecrises
                •Relationshipconflicts
                •Dangeroussurroundings
                                                                                                                                                                                                                  2
     Distress Tolerance Skills                                                                                                                                          10/9/2019
             Checkpoint:
                                                                                                                                    Yellingat
                                                                                                                                    someone
             • Whataresomenegativewaysourpatients                                                           Givingupon                  Usingdrugsor
                dealwithcrises?                                                                                     life                           alcohol
                                                                                                                                   Waysto
                                                                                                                                   Worsen
                                                                                                                                   aCrisis
                                                                                                                  Complainingso                    “Retail
                                                                                                                   muchfolks                    therapy”with
                                                                                                                  don’twantto                   moneyyou
                                                                                                                   talktoyou                    can’taffordto
                                                                                                                                                     spend
                                                                                                                                    Eatingtoo
                                                                                                                                   muchortoo
                                                                                                                                      little
                                                                                                    10
             TeachingDBTDistressTolerance                                                        BehavioralAssessment                                     Step1:
             The4Steps                                                                                                                                     Behavioral
                                                                                                    AskThreeQuestions:                                    Assessment
                                                  Step3:                                           1. Whattriggersthedistress?
                  Step1:         Step2:                         Step4:                              – Bebehavioral–whatweretheydoing?i.e.talkingwitha
                                                   Choose        FollowͲup,                            familymember,thinkingaboutusing,openingmail
                 Behavioral   MakethePitch    Strategy&     Evaluateand
                Assessment                       Determine     ProblemSolve
                                                 Homework                                           2.Howdidthepatientrespondtodistress?
                                                                                                        – Getthebehavioralresponse(i.e.,yelled/startedafight,
                                                                                                          stayedinbedallday)
                                                                                                        – Listenforhelpfulanddestructivebehaviors
                                                                                                    3.Howdidtheirresponsemakethingsworse?
                                                                                                        – Investigatefromthepatient’sperspective
                                                                                                                                                                               3
      Distress Tolerance Skills                                                                                                                                                         10/9/2019
              CaseExample:DS                                                                                Step1:BehavioralAssessment
                                                                                                              CaseExampleͲ DS
                                                                KeyComplaints                                1. Triggers
                 54y/owoman,liveswithhusband    “There’snothingIcandowhenI’m
                 inrecoveryfromOUDfor1month        inpain;I’marguingwithmy                           ൞ Intensebackpainflaresforhours
                      withchronicpainflare           husbandallthetime;Icanno
                                                                longerfunction                               2. Response
                                                                                                                  ൞ Bedbound                             ൞ isolatesself
                   Stoppedopioids1monthago.                                                                   ൞ Doesnoteatorhydrate ൞                 yellsat
                 Longstandinganxiety&depressive    RecentlytransitionedtoSuboxone
                            symptoms:                                                                       3. WhatMadeitWorse                            husband
                    BaselinePHQͲ9=10(mild)             AlsotakingVenlafaxine
                  BaselineGADͲ7=15(moderate)                                                                 ൞ “IfeelsoguiltyafterIyellatmyhusband.He’s
                                                                                                                       justtryingtohelp”
              13                                                                                              14
              MakethePitch                                                                                  Step2:MakethePitch
                                                                              Step2:                        RevisitingCaseExampleͲ DS
              • Explaindistresstolerance                                 MakethePitch                         “Theseareskillstohelpyouwiththeintensepain
                   – Theseareskillstohelpyouwith...(triggers)                                             flaresyouexperience.You’vetoldmeyoutendtoneed
                                                                                                                  tostayinbedformanyhours,noteatordrinkwater,
                   – You’vetoldmeyoutendto... (response)                                                    isolateyourselffromyourfamily,andyellatyour
              • Explainthegoalofdistresstoleranceskills                                                    husband.
                   – Thegoalistonotmakethingsworseandgetthroughthe                                    Thegoalistonotmakethingsworse.Thisisvery
                     situationsafelyͲ differenttomakingyou“feelbetter”                                     differentthan‘feelingbetter.’DTskillshelpyoubring
                   – “DTskillshelpyoubringdownyouremotionssoyouthink                                   downyouremotionssoyouthinkmoreclearly.You’ve
                     moreclearly.”                                                                              toldmethingsareworsewhenyouyellatyour
                   – “You’vetoldmethingsareworsewhenyou(whatwere                                        husband.”
                     negativestotheirnormalresponse)
                                                                                                              16
                                                                                                                                                                                                4
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...Distress tolerance skills zoom housekeeping this call is being recorded dbt please be mindful to not share phi or information that could inadvertently identify a patient mute when speaking anna hink msw licsw audio video controls in lower left corner clinician trainer unmute chat technical issues on off questions anytime uw aims center learning objectives what crisis after training participants should able serious problem there pressure solve can t solved right now the and it difficult stop trying understand purpose of recall emotions are high so s shortterm distressing if happening all time useful for your patients generally life list make things worse you checkpoint stick with kind crises do our run into yes don take eye ball their lives takes no stoptrying unsolvable send through roof focus dt designed just an unsolvedcrisis goals help people survive making face situation cravings triggers many pain flares stressors intended improve feelings though frustrations medical sometimes mor...

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