Dialectical Behavior Therapy
Part of the 3-video series: 3 Approaches to Personality Disorders
In this video, watch Linehan demonstrate her approach with an extremely challenging client who manifests significant Axis II issues. This middle-aged man, brilliantly portrayed by Dutch actor Henk Grashuis, is struggling with depression, suicidal ideation, anger, and a sense that he has been treated unfairly by his ex-girlfriend—all of which is hidden behind a brittle defensiveness. You’ll see Linehan conducting an initial behavioral assessment, interspersed with DBT techniques, including her use of dialectics, irreverence, “validating the valid,” and an emphasis on client choice. While the client works to keep his worst behaviors hidden from Linehan, and is reluctant to commit to any treatment, Linehan carefully, cleverly, and matter-of-factly garners necessary information about him, assesses his suicidality and history of domestic violence, helps him define and commit to his goals, and builds an appropriate initial alliance. You’ll be impressed by how much she accomplishes in a single session!
Note: This video is part of a series, 3 Approaches to Personality Disorders, in which two other masters—psychoanalyst Otto Kernberg and CBT expert Art Freeman—work with the same client.
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-- Shelley McMain, PhD, Head, Borderline Personality Disorder Clinic, University of Toronto
"This video provides a concise, lucid review by Linehan of the origins and nature of DBT, making clear both its essential cognitive-behavioral core but also and most especially the differences. An initial assessment session illustrates a functional analysis of a patient’s problem, and Linehan’s interpolated comments about why she was doing a particular thing are especially helpful in understanding her thinking and strategizing. Overall a very useful training video by a master clinician and scientist."
-- Gerald C. Davison, PhD, Professor of Psychology and Gerontology, University of Southern California
"Linehan provides the viewer with a concise yet thorough overview of the history and development of DBT as well as an update on the latest scientific advances supporting the treatment's efficacy. This discussion is nicely complemented by a clinical demonstration that allows viewers to see elements of DBT in action. The demonstration nicely highlights the importance of a behavioral assessment in DBT while also showcasing the unique interpersonal style of the DBT therapist that is active, matter-of-fact, and can have the effect of keeping the client slightly off balance throughout the session."
-- Jamie Bedics, PhD, Director of DBT Training Program, California Lutheran University
"This video provides an extremely helpful demonstration of the way in which the DBT approach and specific strategies inform an initial consultation session with a client (with presumable Axis II pathology) who presents with both difficult behaviors and a willfulness toward acknowledging the need to change and to engage in therapy...most valuable for use by instructors teaching trainees to become more familiar with the DBT treatment approach, specifically how to implement certain DBT strategies in conducting an initial behavioral assessment. It could also serve to enhance skills in trained DBT therapists, and it provides a solid overview of and glimpse into the DBT clinical style for therapists less familiar with it but interested in knowing more."
-- Beth Brodsky, PhD, reviewed in APA PsycCRITIQUES
"This video is informative, helping the viewer form a clear understanding of the DBT approach. This video is ideal for both novice and seasoned counselors working with clients who present with challenging issues and diagnoses and who need to establish and maintain healthy behavior modification."
-- Kristina Nelson, doctoral student, University of Central Florida, reviewed in The Professional Counselor
In this initial session, Linehan works with a fascinating and difficult client. He makes it clear that he is actively suicidal, has little faith in therapy, and is not necessarily committed to treatment. He bobs and weaves as Linehan works with him, concealing some of the most damaging aspects of his own past behaviors and painting himself as an angry and wounded victim. With her upfront and frank style, Linehan defines the client’s goals, makes clear to him which behaviors must change immediately, and gets him to agree to postpone suicidality in favor of further investigating her treatment. Throughout the session, Linehan gives voiced-over explanations of why she made certain choices and what compelled her towards different interventions. Prepare to be fascinated, both by the client and by Linehan!
Note: This video is part of a series, Three Approaches to Personality Disorder. The other two titles feature psychoanalyst Otto Kernberg and CBT expert Art Freeman conducting sessions with the same client.
By watching this video, you will learn:
- How to conduct an initial behavioral assessment using DBT
- How to implement elements of DBT style and strategy with your own clients
- How a DBT therapist assesses for suicidality and obtains commitment to therapy
She is the developer of Dialectical Behavior Therapy (DBT), a treatment originally developed for the treatment of suicidal behaviors and since expanded to treatment of borderline personality disorder and other severe and complex mental disorders, particularly those that involve serious emotion dysregulation.
See all Marsha Linehan videos.
- Understand how to conduct an initial behavioral assessment using DBT
- Utilize elements of DBT style and strategy with your own clients
- Describe how DBT therapist assesses for suicidality and obtains commitment to therapy