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DBT for Psychosis: Radical Acceptance and Therapy-Interfering Behaviors Dr. Kirby Reutter, DBTC, LMHC, MAC & Maggie Mullen, LCSW 0 Content Introduction 2 Transcript PTSD and Interpersonal E ectiveness Skills 3 Transcript Applying Validation 4 Transcript Using Irreverence With Clients With Psychosis 6 Transcript Radical Acceptance and Psychosis 7 Transcript Dealing With Treatment-Interfering Behaviors 9 Transcript Main Points 11 Transcript 1 Introduction In the final segment of this interview series on DBT and psychosis, Maggie Mullen explores a variety of topics related to the following themes: validation, radical genuineness, clinical irreverence, and radical acceptance. Maggie further discusses how they help clients manage treatment-interfering behaviors and the importance of providing psychoeducation, especially including the normalization of psychotic symptoms. Maggie concludes the interview by identifying which DBT skills they use in their personal life. 2 PTSD and Interpersonal E ectiveness Skills Kirby How do you apply interpersonal effectiveness skills to clients with psychotic disorders with PTSD? Maggie One of the things I love about your workbook is the focus on these skills for clients with PTSD. The rates of PTSD for clients with psychosis are also high. They’re assumed to be at least 30%—probably higher because people don’t always self-report and clinicians don’t screen. When we’re thinking about interpersonal effectiveness skills, the core part of PTSD or trauma is the idea of avoidance. For clients, it can be common to encounter difficulties when they have to say no due to past traumatic experiences. They may also find it difficult to ask for something they need. We have to work on what was originally a survival skill. If the client is now in a relatively safe environment, it’s important to teach them to ask for their needs to be met in a way that helps them. 3
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