“Recovery is a journey, and we provide a foundation that behavioral health professionals can build on in subsequent outpatient settings,” says Catie Giarra, LCSW, Senior Primary Therapist at the Moorestown outpatient site. “Therapists can refresh and reteach DBT skills while exploring any everyday, real-life situations that may be impeding their use.”
While every patient’s needs are different, Giarra finds that reinforcing these DBT skills can be particularly effective:
MINDFULNESSObserve, describe, and participate: Patients can practice mindfulness by using the five senses to notice what’s happening in that moment, putting words to the experience, and entering fully into that moment while letting go of judgment. This exercise can even be practiced with a therapist during a counseling session.
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EMOTION REGULATIONOpposite to emotion action. If patients are struggling with anxiety that hinders them from doing something, they can choose to actively do the opposite. For example, if work is causing anxiety, approaching the cause of anxiety by going to work—and repeating that behavior—can eventually remove that anxiety.
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DISTRESS TOLERANCEDistract with “the wise mind accepts.” The acronym “accepts” can remind patients of these distraction techniques for distress tolerance: (A) activities: biking, going to the gym, or doing something enjoyable (C) contributing: helping others, such as making dinner for a friend (C) comparisons: comparing the present to successful coping skills during an earlier time (E) emotions: engaging opposite emotions, such as by watching a funny movie (P) pushing away: actively containing negative thoughts (T) thoughts: engaging other thoughts, such as by naming everything in the room (S) sensations: activating the five senses, like by touching a soft blanket or a cold ice pack
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INTERPERSONAL EFFECTIVENESSNo absolute truth. When patients allow space for other perspectives, it can reduce suffering. It helps to reinforce the fact that when someone else has another point of view, it doesn’t mean that the patient’s perspective is wrong.
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STAFF PRACTICE, TOOEvery morning before case reviews, staff at the Women’s Program begin the meeting with a mindfulness practice. “It centers us, makes the meeting more effective, and helps us communicate with clearer minds,” says Giarra.
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Some patients may continue to engage in unsafe behaviors even with insight about DBT strategies, according to Giarra, which is why ongoing practice is so important.
“We need to practice any behavior we learn, and coping strategies are no different,” she explains. “Building a toolbox of DBT skills is part of the self-care journey, but practicing how to use these tools is just as critical. The path to change is much easier when you have a good coach in your corner to remind you how to practice and why it helps.”
For more information about the Women’s Program at Princeton House, visit princetonhouse.org/women or call 888.437.1610.
Article as seen in the Fall 2018 issue of Princeton House Behavioral Health Today.
