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DBT. Recovery. CBT/Behaviourism.

DBT. Recovery. CBT/Behaviourism. Common Core Philosophy. Hope. Central to Recovery. DBT: the life worth living. CBT. Cognition and behaviour can change. You can choose. Working with strengths. All look at the whole person, not the pathology.

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DBT. Recovery. CBT/Behaviourism.

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  1. DBT. Recovery. CBT/Behaviourism. Common Core Philosophy

  2. Hope. • Central to Recovery. • DBT: the life worth living. • CBT. Cognition and behaviour can change. You can choose.

  3. Working with strengths.All look at the whole person, not the pathology. • Recovery: regaining or developing valued roles. • DBT. Encouraging mastery. • CBT. Focus on behaviour to increase – what the person can do as opposed to what they do wrong.

  4. Normalisation. • Recovery. Building a life outside the services; employment focus. • DBT. Biopsychosocial model applies to some degree to everyone. • CBT. We all have dysfunctional thinking patterns and challenging behaviours sometimes.

  5. Common humanity, common vulnerability. • Recovery. Trainers devise their own WRAP plans. Encouragement of employment of those who have recovered in the services (experts by experience). • DBT. Therapists note own therapy intefering behaviours, dialectical dilemmas and emotion mind. • CBT. Therapists monitor the effect of challenging behaviour on their own arousal systems and thought patterns, and sidestep reproducing the pattern or responding from the raised state of arousal.

  6. Collaboration. • Recovery; service user sets the agenda. • DBT. Client must agree to work on reducing self harm as a first priority, but the life worth living is their own vision. • CBT – goals of therapy are arrived at collaboratively.

  7. Accepting reality • Recovery. The concept of the turning point means the point at which the individual recognises whatever limitations are imposed by their problems, and accepts what has happened in the past – this makes taking ownership of their future possible. • DBT. Acceptance is a core concept. • CBT. Individual needs to be prepared to take responsibility for change.Work on changing what’s changeable - no point challenging an unchallengeable thought.

  8. Self Monitoring • Recovery: PIP.Identify wellness, and then triggers and early warning signs for relapse. Relapse is a normal part of recovery. • DBT: Diary cards.Chain analysis. • CBT: Thought Diaries.

  9. Response to Risk and challenge. • Recovery. PIP – individual responsibility for maintaining wellness and specifying what should happen in case of breakdown. • DBT. Skills training, featuring mindfulness, to master action urges. • CBT. Specifying behaviours to increase and reinforcing them is the most efficient way to decrease challenging behaviours.

  10. Idea of Balance and Finding a Middle Way • Recovery. Balance between learning to live with symptoms and a relapsing condition, and making the most of life. • DBT. Always looking for the dialectic, and for the wisdom in both poles while seeking a way through. There is no one right way – the process carries on. • Behavioural approach to challenging behaviour – balancing the obvious, behaviours to decrease with emphasis on behaviours to increase. • CBT: you can choose the most helpful way to think about things.

  11. Unique features • Recovery. Service users, not professionals, in charge. • DBT. Skills training and mindfulness. • CBT. Individual formulation of difficulties. However – the similarities are more striking and numerous than the differences.

  12. Common Core Philosophy. • Hope • Working with strengths. • Normalisation. • Common humanity, common vulnerability. • Collaboration. • Accepting reality. • Idea of Balance and Finding a Middle Way. • Proactive, collaborative response to risk and challenge.

  13. Implications for staff role. • Staff need to hold hope and vision for the individual even when they cannot yet see it. • Staff need to concentrate their efforts on identifying and working with the person’s strengths and interests. • Staff need to see the person as they might fit into society to help them maximise their prospects. They need to listen to the person and take seriously what they say. • Staff need to be aware of and manage their own emotional reactions. • Staff need to develop their skill in working collaboratively. • Staff have a vital role in enabling the person to accept what has happened and its consequences, and take responsibility for continuing problems. • Staff must keep in mind the need to balance working with strengths with realistic support with problems. • In managing risk, staff need to seek the full collaboration of the service user.

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