Master Clinician Seminar 1 - Managing Therapy Interfering Behavior in DBT and Beyond
Friday, November 15, 2024
8:30 AM – 10:30 AM EST
Location: 308, Level 3, Downtown Marriott
Earn 2 Credit
Keywords: DBT (Dialectical Behavior Therapy), Change Process / Mechanisms, Therapeutic Alliance Level of Familiarity: Basic Recommended Readings: Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Guilford press., Miller, A. L., Rathus, J. H., & Linehan, M. M. (2006). Dialectical behavior therapy with suicidal adolescents. Guilford Press., Koerner, K. (2011) Doing Dialectical Behavior Therapy: A Practical Guide. Guildford Press., Shaller, E.A.L. (Anticipated Publication October 2024). Therapy Interfering Behavior in Dialectical Behavior Therapy. Guilford., Allen, D. M. (1997). Techniques for reducing therapy-interfering behavior in patients with borderline personality disorder: Similarities in four diverse treatment paradigms. Journal of Psychotherapy Practice & Research, 6(1), 25-35.
Clinical Professor UC San Francisco Berkeley, California, United States
Dialectical Behavior Therapy (DBT) has helped to bring many tools into the mainstream of behavior therapy, including mindfulness, strategic self-disclosure, and dialectical thinking. One of the most useful concepts can be applied regardless of whether one is implementing comprehensive DBT: the direct labeling and addressing of “therapy interfering behavior,” or TIB.
Because TIB is so common, our definition is also broad. TIB is any behavior on the part of either the clinician or the client that gets in the way of DBT’s central goal—that the therapist and client continue to work together (Linehan, 1993). TIB can also reduce the overall effectiveness of the work of a client and therapist, even when both remain committed to the treatment. TIB can be purposeful—vindictive, even!— and also entirely unintentional. Regardless of intent, TIB can wreak havoc on an otherwise solid treatment plan!
As evidenced by the title, this talk is grounded in dialectical behavior therapy (DBT). Yet every client and every therapist will engage in TIB from time to time. Over many years I have taught trainees from a variety of professional backgrounds and therapeutic orientations how to systematically and non-judgmentally address and target TIB in all of their clients, regardless of the treatment plan. Some were working with clients in DBT, but many others were doing short-term stabilization on an inpatient unit, monthly medication management, cognitive behavioral therapy, or even other forms of psychotherapy. The tools and principles in this talk should enhance any clinician’s ability to have frank conversations with their clients about what might be getting in the way of their most effective work together.
In this two hour workshop, you will learn: How to orient a client to the concepts of TIB and how to elicit their help in managing them How to assess TIB with a new client and throughout the course of treatment How to effectively address TIB in the client How to effectively address TIB in yourself
Didactic portions will be broken up by live role plays and experiential practice in assessing and addressing TIB. Clinicians should come away confident in their abilities to address common TIBs such as lateness, not doing homework, avoidance in session, “yes-butting,” “I don’t knows,” and many more!
Learning Objectives:
At the end of this session, the learner will be able to:
Define “therapy interfering behavior” and identify three reasons to address it effectively with clients.
Be able to effectively orient a client to the idea of addressing both client and therapist therapy interfering behavior.
Describe three therapist skills needed to effectively address therapy interfering behavior.
Describe three steps to effectively address therapy interfering behavior in session.
Differentiate between times when it would be effective to directly address therapy interfering behavior versus when it would be best to use extinction procedures.
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