This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Friday, August 31, 2012

Books and Methods Review - Methods - Dialectical Behavior Therapy/ Mindfulness




Dialectical behavior therapy (DBT) is a system of therapy originally developed by Marsha M. Linehan, a psychology researcher at the University of Washington, to treat people with borderline personality disorder (BPD). DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. 

DBT may be the first therapy that has been experimentally demonstrated to be generally effective in treating BPD. A meta-analysis found that DBT reached moderate effects. 


Research indicates that DBT is also effective in treating patients who present varied symptoms and behaviors associated with spectrum mood disorders, including self-injury (like cutting). Recent work suggests its effectiveness with sexual abuse survivors and chemical dependency. - Wikipedia

Marythemom:  this is an effective therapy that goes beyond CBT (Cognitive Behavior Therapy), but it does require emotional awareness and cognitive abilities that my own children just don’t have.  It is usually group therapy (although it doesn't have to be) that helps a person do a reality check on their thinking.  It is currently one of the best treatments for Borderline Personality Disorder. Unfortunately, it doesn't work for my children, because they do not have the emotional awareness, cognitive abilities or impulse control that they would need.




DBT Distress Tolerance Skills: Your 6-Skill Guide to Navigate Emotional Crises

We all experience crises in our lives. Sometimes these crises are big, like a divorce, a death, or a layoff. Sometimes these crises are small, like traffic, a long line at check out, or not knowing what to wear that day. DBT distress tolerance skills help you get to a more manageable emotional place for crisis survival.


SKILL 1: TIPP
You’re at your emotional breaking point. Maybe the worst has happened, or maybe it was just the “last straw”. The DBT distress tolerance skill you need is TIPP. This skill is designed to bring you down from the metaphorical (hopefully not literal) ledge.


TIPP stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation.



TEMPERATURE

When we’re upset, our bodies often feel hot. To counter this, splash your face with cold water, hold an ice cube, or let the car’s AC blow on your face. Changing your body temperature will help you cool down—both physically and emotionally.

INTENSE EXERCISE

Do intense exercise to match your intense emotion. You’re not a marathon runner? That’s okay, you don’t need to be. Sprint down to the end of the street, jump in the pool for a few laps, or do jumping jacks until you’ve tired yourself out. Increasing oxygen flow helps decrease stress levels. Plus, it’s hard to stay dangerously upset when you’re exhausted.

PACED BREATHING

Even something as simple as controlling your breath can have a profound impact on reducing emotional pain. There are many different types of breathing exercises. If you have a favorite, breathe it out. If you don’t, try a technique called “box breathing”. Each breath interval will be four seconds long. Take in air four seconds, hold it in four seconds, breathe out four, and hold four. And then start again. Continue to focus on this breathing pattern until you feel more calm. Steady breathing reduces your body’s fight or flight response.

PAIRED MUSCLE RELAXATION

The science of paired muscle relaxation is fascinating. When you tighten a voluntary muscle, relax it, and allow it to rest, the muscle will become more relaxed than it was before it was tightened. Relaxed muscles require less oxygen, so your breathing and heart rate will slow down.1
Try this technique by focusing on a group of muscles, such as the muscles in your arms. Tighten the muscles as much as you can for five seconds. Then let go of the tension. Let the muscles relax, and you’ll begin to relax, as well.




























































The distress tolerance skills in TIPP will bring you a step closer to wise mind, where you will be able to make a constructive choice and cope productively.

This is a good article for more skills - DBT Distress Tolerance Skills: Your 6-Skill Guide to Navigate Emotional Crises


DBT Books

Marythemom: I haven't reviewed any of these books.  I just got some binders from the treatment center Kitty went to.  


This is a list of DBT/ Mindfulness books I got from Amazon:  http://www.amazon.com/Best-Dbt-Mindfulness-Books-Ever/lm/R225PPUEW3CCTI


The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & ... Tolerance 

by Matthew McKay (Author), Jeffrey C. Wood (Author), Jeffrey Brantley (Author)
A Clear and Effective Approach to Learning DBT Skills - First developed for treating borderline personality disorder, dialectical behavior therapy (DBT) has proven effective as treatment for a range of other mental health problems, especially for those characterized by overwhelming emotions. Research shows that DBT can improve your ability to handle distress without losing control and acting destructively. In order to make use of these techniques, you need to build skills in four key areas-distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness.



The Dialectical Behavior Therapy Skills Workbook
A collaborative effort from three esteemed authors- offers straightforward, step-by-step exercises for learning these concepts and putting them to work for real and lasting change. Start by working on the introductory exercises and, after making progress, move on to the advanced-skills chapters. Whether you are a professional or a general reader, whether you use this book to support work done in therapy or as the basis for self-help, you'll benefit from this clear and practical guide to better managing your emotions.
This book has been awarded The Association for Behavioral and Cognitive Therapies Self-Help Seal of Merit — an award bestowed on outstanding self-help books that are consistent with cognitive behavioral therapy (CBT) principles and that incorporate scientifically tested strategies for overcoming mental health difficulties. Used alone or in conjunction with therapy, our books offer powerful tools readers can use to jump-start changes in their lives.


Temper tantrums in the supermarket. Tears that seem to come out of nowhere. Battles over homework that are more like wars. When your child has problems regulating his or her emotions, there's no hiding it. Children with intense emotions go from 0 to 100 in seconds and are prone to frequent emotional and behavioral outbursts that leave parents feeling bewildered and helpless.
Other parents may have told you that it's just a phase or that your child needs discipline. In reality, your child may have emotion dysregulation, a tendency to react intensely to situations other children take in stride. Parenting a Child Who Has Intense Emotions is an effective guide to de-escalating your child's emotions and helping your child express feelings in productive ways. You'll learn strategies drawn from dialectical behavior therapy (DBT), including mindfulness and validation skills, and practice them when your child's emotions spin out of control. This well-researched method for managing emotions can help your child make dramatic emotional and behavioral changes that both of you will be proud of.



Many of us are walking around half unconscious to who we are and what makes us truly happy. This costs us in terms of missed opportunities to experience the thrill of life, not being able to tap into the source of our power, wandering aimlessly and searching for a better life, and feeling disconnected from our Self, our loved ones and the world. It doesn't take much for you to wake up, become mindfully aware in the moment, and respond authentically to life. When you let your whole life become a meditation in progress, you don't need to take much extra time or go out of your way to create the rich, rewarding, and enjoyable life that is meant to be yours. This book is stripped down to the basic essence of mindfulness meditation, offering 85 simple practices that will quickly help you: - find the juice and joy inside and all around you; - find the strength to take whatever you do to the next level; - find your core purpose so you always make the right choices; - find the courage to follow your heart and love deeply; and - ultimately, find your inner peace.


This groundbreaking book gives clinicians a new set of tools for helping people overcome binge-eating disorder and bulimia. It presents an adaptation of dialectical behavior therapy (DBT) developed expressly for this population. The treatment is unique in approaching disordered eating as a problem of emotional dysregulation. Featuring vivid case examples and 32 reproducibles, the book shows how to put an end to binge eating and purging by teaching clients more adaptive ways to manage painful emotions. Step-by-step guidelines are provided for implementing DBT skills training in mindfulness, emotion regulation, and distress tolerance, including a specially tailored skill, mindful eating.


Though acceptance and mindfulness interventions have proven enormously effective for adults with stress, anxiety, depression, and other mental health issues, they have not been fully documented for use with children and adolescents. And yet they are a natural fit for children's therapy-the focus on acceptance and mindfulness builds children's psychological flexibility, and the values component of these methods helps young people learn to set goals and take action to achieve them.

The chapters in Acceptance and Mindfulness Treatments for Children and Adolescents show how to modify third-wave behavioral and cognitive therapy methods for the treatment of children and adolescents. This book also considers the early evidence for the adaptability and effectiveness of these methods. Edited by two luminaries in the field of third-wave behavior therapy, these essays will be invaluable in helping young patients reap the benefits of acceptance and mindfulness approaches such as acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and mindfulness-based stress reduction (MBSR).



  • Learn how ACT, DBT, MBCT, and MBSR can be used with young people and their families
  • Discover recent third-wave behavior therapy research
  • Explore the practice issues that arise when acceptance and mindfulness techniques are used with children and adolescents
  • Find out how to put these techniques to work in your own practice

The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder: Using DBT to Regain Control of Your Emotions and Your Life (New Harbinger Self-Help Workbook) 

by Sheri Van Dijk MSW
Even if you've just been diagnosed with bipolar disorder, it's likely that you've been living with it for a long time. You've probably already developed your own ways of coping with recurring depression, the consequences of manic episodes, and the constant, uncomfortable feeling that you're at the mercy of your emotions. Some of these methods may work; others might do more harm than good. The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder will help you integrate your coping skills with a new and effective dialectical behavior therapy (DBT) plan for living well with bipolar disorder.

The four DBT skills you'll learn in this workbook-mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness-will help you manage your emotional ups and downs and minimize the frequency and intensity of depressive and manic episodes. By using this book in conjunction with medication and professional care, you'll soon experience relief from your bipolar symptoms and come to enjoy the calm and confident feeling of being in control.

  • Learn mindfulness and acceptance skills
  • Cope with depressive and manic episodes in healthy ways
  • Manage difficult emotions and impulsive urges
  • Maintain relationships with friends and family members

Don't Let Your Emotions Run Your Life for Teens: Dialectical Behavior Therapy Skills for Helping You Manage Mood Swings, Control Angry Outbursts, and get along with Others (Instant Help Book for Teens) 

by Sheri Van Dijk MSW
Let's face it: life gives you plenty of reasons to get angry, sad, scared, and frustrated-and those feelings are okay. But sometimes it can feel like your emotions are taking over, spinning out of control with a mind of their own. To make matters worse, these overwhelming emotions might be interfering with school, causing trouble in your relationships, and preventing you from living a happier life.
Don't Let Your Emotions Run Your Life for Teens is a workbook that can help. In this book, you'll find new ways of managing your feelings so that you'll be ready to handle anything life sends your way. Based in dialectical behavior therapy (DBT), a type of therapy designed to help people who have a hard time handling their intense emotions, this workbook helps you learn the skills you need to ride the ups and downs of life with grace and confidence.



DBT Therapists and psychiatrists 

Psychology Today - I really like using this website for searching for therapists/psychiatrist, because it allows me to choose based on location (search by city or zip code), specialties (child and adolescent, EMDR, trauma…), insurance (do they accept Medicaid, BCBS, UBH…?), you can even search by gender (I have a child who can’t have a male therapist).  Do be aware that they have to pay to be on this list so it's not likely to have every therapist available. 


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