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picture1_Learning Pdf 109180 | Distress Tolerance Presentation Handout


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File: Learning Pdf 109180 | Distress Tolerance Presentation Handout
learning objectives dbt distress tolerance skills after this training participants should be able to determine when to use dbt s distress anna hink msw licsw tolerance skills with your patients ...

icon picture PDF Filetype PDF | Posted on 27 Sep 2022 | 3 years ago
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                                                                                                                  LearningObjectives
                 DBTDistressToleranceSkills                                                                   Afterthistraining,participantsshouldbeable
                                                                                                                  to:
                                                                                                                  • DeterminewhentouseDBT’sDistress
                 AnnaHink,MSW,LICSW                                                                               Toleranceskillswithyourpatients
                 ClinicianTrainer                                                                                • ListtheDistressToleranceskills
                 UWAIMSCenter                                                                                  • IntegratetheuseofDistressToleranceskills
                                                                                                                     intoyourpractice
                                                                                                                  2
              CaseExample:DS                                                                                    WhatIsACrisis?
                                                                  KeyComplaints                                       Aseriousproblemthat             Thereispressuretosolve
                 54y/oHispanicwoman,liveswith     “There’snothingIcandowhenI’m                          can’tbesolvedrightnow                theproblem,anditis
                       husband,somecollege                inpain;I’marguingwithmy
                                                         husbandallthetime;I’mworried                                                                  difficulttostoptrying
                                                             aboutcancerreturning”
                                                                                                                                                     Crisis
                  OUD.Stoppedopioidsx1week.         BuprenorphineͲNaloxone24Ͳ8mg
                 Longstandinganxiety&depressive                     qd                                           Emotionsarehigh,sothe                    It’sshortͲterm
                             symptoms:                     VenlafaxineXR275mgqd                                    problemisdistressing             Ifitishappeningallthetime,
                     BaselinePHQͲ9=10(mild)                                                                       Highemotionsgenerally             itisnotacrisis.Itisyourlife!
                  BaselineGADͲ7=15(moderate)                                                                          makethingsworse
               3                                                                                                  4
             CanYouSolveTheCrisis?                                                              WhoAreDistressToleranceSkillsFor?
                                 •  Stickwithit                                                               Patients                          Clinicians
               IfYes…           •  Don’ttakeyoureyeofftheball                                         facemanystressors               facemanystressors
                                 •  Dowhatittakes!                                              • Painflares                       • Largecaseloads
                                                                                                    • Frustrationswithmedicalcare    • Difficultandsickpatients
                                                                                                    • Intenseemotions                  • Hearingmanytraumaticstories
                 IfNo          • STOPtryingtosolveit                                            • Familyconflicts                  • Inabilitytohelptheirpatients
                                • Tryingtosolvetheunsolvablecanmakeit                       • Housingissues                    • Lackoftimeorresourcestohelp
                                                                                                    • Moneyissues                       theirpatients
             (ornotright       worseorsendemotionsthroughtheroof                                                                                     with
                                • FocusonDistressTolerance skills                                • Drugsandalcohol                 • Frustratinginteractions
                now)…                                                DTskillsare                • Dangerousneighborhoods           socialservices
                                                                    designedjustfor              • Longwaitsforsocialservices    • Unhelpfulrulesorregulations
                                                                    anunsolvedcrisis                                                   • Paperwork
             5                                                                                      6
             PurposeofDistressToleranceSkills                                                                                   Yellingat
                                                                                                                                    someone
             • Helpyousurvivethecrisisbynotmakingthe                                                      Givingupon                  Usingdrugsor
                situationworse                                                                                       life                           alcohol
             • Notintendedtomakeyoufeelbetter(though                                                                       Waysto
                sometimesyoumight)                                                                                               Worsen
                                                                                                                                   aCrisis
                                                                                                                  Complainingso                    “Retail
             • Ifskillspreventthecrisisfromgettingworse,                                                   muchfolks                    therapy”with
                                                                                                                  don’twantto                   moneyyou
                butyoudonotfeelbetterͲ don’tstop!                                                          talktoyou                    can’taffordto
                                                                                                                                                     spend
                – Anescalatedcrisismaymakeyoufeelworse                                                                       Eatingtoo
                                                                                                                                   muchortoo
                                                                                                                                      little
             7                                                                                      8
                BenefitsofDistressToleranceSkills                                                                       DBTDistressTolerance:The4Steps
                • Learntosurvivea
                   crisiswithout
                   makingitworse                                                                                               Step1:                                 Step3:              Step4:
                                                                                                                                                    Step2:              Choose            FollowͲup,
                • Becomemore                                                                                                 Behavioral      MakethePitch          Strategy&        Evaluateand
                                                                                                                              Assessment                                Determine         ProblemSolve
                   confidentand                                                                                                                                       Homework
                   capableof
                   navigatingfuture
                   crises
                9                                                                                                           10
                Step1:BehavioralAssessment                                                                               Step1:BehavioralAssessment
                AskThreeQuestions:                                                                                       RevisitingCaseExampleͲ DS
                1. Whattriggersthedistress?                                                                              1. Triggers
                     –Bebehavioral(i.e.,talkingwithafamilymember,                                                       ൞ Intensebackpainflaresforhours
                        thinkingathought)                                                                                     ൞ Tendstooverdothingswhenfeelingbetter
                2.Howdidthepatientrespondtodistress?                                                                  2. Response
                     –Bebehavioral(i.e.,yelled/startedafight,stayedin                                                   ൞ Bedbound                                  ൞ isolatesself
                        bedallday)                                                                                            ൞ Doesnoteatorhydrate ൞                      yellsathusband
                     –Listenforhelpfulanddestructivebehaviors                                                          3. WhatMadeitWorse
                3.Howdidtheirresponsemakethingsworse?                                                                     ൞ “IfeelsoguiltyafterIyellatmyhusband.He’s
                     –Fromthepatient’sperspective(notyoursasthe                                                              justtryingtohelp”
                        provider)!
                11                                                                                                          12
            DBTDT:The4Steps                                                               Step2:MakethePitch
                                                                                              • Explaintheconceptofdistresstolerance
                                                                                                  –“Theseareskillstohelpyouwith(1.triggers).
                                                                                                    You’vetoldmeyoutendto(2.response).”
                                               Step3:         Step4:
                Step1:        Step2:        Choose
               Behavioral                    Strategy&     FollowͲup,                    • Explainthegoalofdistresstoleranceskills
               Assessment   MakethePitch    Determine     Evaluateand                        –“Thegoalistonotmakethingsworse.Thisis
                                              Homework      ProblemSolve                           verydifferentthan‘feelingbetter.’”
                                                                                                  –“DTskillshelpyoubringdownyouremotionsso
                                                                                                    youthinkmoreclearly.”
                                                                                                  –“You’vetoldmethingsareworsewhenyou(3.
                                                                                                    whatmadeitworse).”
            13                                                                                14
            Step2:MakethePitch                                                           DBTDT:The4Steps
            RevisitingCaseExampleͲ DS
                “Theseareskillstohelpyouwiththeintensepain
                flaresyouexperience.You’vetoldmeyoutendtoneed
                tostayinbedformanyhours,noteatordrinkwater,                                                          Step3:         Step4:
                isolateyourselffromyourfamily,andyellatyour                              Step1:        Step2:        Choose
                husband.                                                                         Behavioral                    Strategy&     FollowͲup,
                                                                                                Assessment    MakethePitch    Determine     Evaluateand
                                                                                                                               Homework       ProblemSolve
                Thegoalistonotmakethingsworse.Thisisvery
                differentthan‘feelingbetter.’DTskillshelpyoubring
                downyouremotionssoyouthinkmoreclearly.You’ve
                toldmethingsareworsewhenyouyellatyour
                husband.”
            15                                                                                16
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...Learning objectives dbt distress tolerance skills after this training participants should be able to determine when use s anna hink msw licsw with your patients clinician trainer list the uw aims center integrate of into practice case example ds what is a crisis key complaints serious problem that there pressure solve y o hispanic woman lives nothing i can do m t solved right now and it husband some college in pain arguing my all time worried difficult stop trying about cancer returning oud stopped opioids x week buprenorphinenaloxone mg longstanding anxiety depressive qd emotions are high so shortterm symptoms venlafaxine xr distressing if happening baseline phq mild generally not life gad moderate make things worse you who for stick clinicians yes don take eye off ball face many stressors takes flares large caseloads frustrations medical care sick intense hearing traumatic stories no stoptrying family conflicts inability help their unsolvable housing issues lack or resources money se...

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