Dialectical Behavior Therapy Techniques for Emotional Dysregulation
by Shelley McMain and Carmen Wiebe
How can you stay centered while supporting clients through periods of extreme reactivity and self-harm? In this video with Drs. Shelley McMain and Carmen Wiebe, learn to apply key tools from Dialectical Behavior Therapy (DBT) to work with emotional dysregulation.

Part of the 6-video series: Psychotherapy Essentials to Go
Highly reactive clients can test the empathy of even the most compassionate therapists—so how do we support them and also stay grounded ourselves? This video offers answers in the form of compelling strategies taken from Marsha Linehan’s venerable Dialectical Behavior Therapy (DBT). Here, DBT experts Drs. Shelley McMain and Carmen Wiebe demonstrate a selection of key interventions from the method, designed to help clients navigate waves of emotional dysregulation. What’s more, they outline the essential DBT mindset that will help you, the therapist, maintain your own equilibrium in the room.

In a series of brief didactic interviews alongside clinical vignettes, Wiebe and McMain reveal how to integrate specific techniques into challenging sessions. Focused here on helping a female client eliminate self-harming behaviors, they present core DBT theories, emphasize the quality of the client-therapist dyad, and promote the use of validation, commitment strategies, problem solving, and distress tolerance skills training.

You’ll get an overview of the three core tenets of DBT—learning theory, Zen philosophy, and dialectics—which together form the therapist’s guiding framework for the model. You’ll understand the significance of an invalidating early environment, and find eight DBT assumptions about clients that can help you stay compassionate. Practical skills are covered as well, including validation techniques, strategies to gain and keep a client’s commitment, and problem-solving methods that enhance deeper treatment. Most important, McMain and Wiebe present effective distress tolerance skills that you can incorporate into your work right away.

While each clinician has a different style, they both convey firm guidance alongside tangible warmth and empathy; their client gains valuable insight and tools that eventually lead to significant improvement. This video is an excellent resource for anyone seeking a DBT primer, tools for handling emotional dysregulation, or simple reassurance that you’re not alone in feeling challenged by this work. Check it out today.

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What therapists are saying…

"Psychotherapy Essentials To Go is a truly impressive series of videos. Elevating pragmatics over dogma, it is grounded in the wisdom of front-line psychotherapists who adapt the core principles of empirically supported psychotherapies to flexibly address a myriad of clinical issues. No other series of psychotherapy videos is as skillfully concise and yet thorough. It will quickly become a standard reference for teaching and enhancing clinical competence."

-- Zindel V. Segal, PhD, Distinguished Professor of Psychology in Mood Disorders, University of Toronto–Scarborough; author of The Mindful Way Through Depression
"In this training video, the nuanced reasons for how DBT skills work and how to approach emotionally dysregulated clients is presented in a simple and straightforward manner with ample "practice" examples in the mock client sessions. Very useful indeed."

-- Margaret Evanow, MS, LPCC, DBT Certified Counselor
"I highly recommend this video for individuals new to DBT and practitioners working with individuals with a BPD diagnosis that need help to comprehend and treat their patients more skillfully. Clinical Training Programmes for a range of mental health professionals would also find this video of value as part of their teaching materials. The presenters provide an engaging mix of didactic material interspersed with demonstration role-plays of aspects of DBT. This well-produced video provides a clear, understandable introduction to key theories, principles and practices of DBT."

-- Dr. Michaela Swales PhD, CPsychol, AFBPsS, Consultant Clinical Psychologist & Reader, Betsi Cadwaladr University Health Board & North Wales Clinical Psychology Programme, co-author of Changing Behavior in DBT: Problem-Solving in Action
"Definitely a good refresher...Showing both description and demonstration in small steps was wonderful. It makes the material and skills easy to comprehend and implement...The video appeals to more than one learning style and the combination of styles helps insure the skills taught will be integrated into actual therapy sessions...I would definitely recommend the video and will require it as training for any new therapists joining my practice."

-- Valencia Agnew, PhD, DBTC
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When a client enters the room in a palpably agitated state—or experiences chronic emotional dysregulation over time—how do we support their calming response while remaining calm ourselves? In this reassuring training video, DBT experts Drs. Shelley McMain and Carmen Wiebe demonstrate an invaluable array of key interventions from Dialectical Behavior Therapy (DBT), uniquely geared toward helping clients surf the waves of emotional reactivity and suicidal ideation. You’ll find much to implement in this hour-long presentation.

Here, McMain and Wiebe are focused on helping Ashley, a young woman with a history of self-harm and interpersonal tensions. In a series of brief didactic interviews alongside clinical vignettes, they illustrate the effective use of validation, commitment strategies, problem solving, and distress tolerance skills training. You’ll discover the three core tenets of DBT: learning theory, Zen philosophy, and dialectics. You’ll also learn about the significance of an invalidating early environment on a client’s current presentation, and find eight DBT assumptions about clients that can help you stay compassionate. Practical skills are covered as well, including validation techniques; commitment strategies such as devil’s advocate, pros and cons, and more; the AVIS-R skills coaching protocol; behavioral and solution analyses; and making collaborative thought records. Finally, McMain and Wiebe present distress tolerance skills that you can start using with your clients today.

While each host has a different style, they both remain firmly in command of the session while also communicating genuine concern and empathy. By the video’s end, Ashley reports in a separate epilogue that she has a deeper understanding of her anxiety and self-harm, feels more in control of her life, and has abstained from cutting herself for three months.

With its rich set of takeaways, this video offers practical tools to support your work with clients in distress. If you’re in search of integral resources on DBT, emotional dysregulation, or distress tolerance skills, be sure to add this to your library.

By watching this video, you will:
  • Understand the theoretical underpinnings of DBT and its application to emotional dysregulation.
  • Learn how to communicate your understanding of what makes sense about a client’s experience (i.e., validation).
  • Discover ways to incorporate commitment strategies, problem-solving tools, and distress tolerance skills into your client work.

Length of video: 01:01:20

Number of Discs: 0

English subtitles available on: Stream

This DVD plays in

Group ISBN-13 #: 978-1-60124-516-8

Shelley McMain, PhD, a researcher, clinician, and educator, is head of the Borderline Personality Disorder (BPD) Clinic and head of Personality Disorder Capacity Building and Research in the Women’s Program at the Centre for Addiction and Mental Health in Toronto, Canada. She is also Associate Professor in the Department of Psychiatry at the University of Toronto.

Carmen Wiebe, MD, is Assistant Professor in the Department of Psychiatry at the University of Toronto, where she coordinates Dialectical Behavior Therapy education for the postgraduate program. She also works in the Borderline Personality Disorder Clinic at the Centre for Addiction and Mental Health.

CE credits: 1

Learning Objectives:

  • Understand the theoretical underpinnings of DBT and its application to emotional dysregulation.
  • Learn how to communicate your understanding of what makes sense about a client’s experience (i.e., validation).
  • Discover ways to incorporate commitment strategies, problem-solving tools, and distress tolerance skills into your client work.
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