Challenges in DBT for Depression

Dennis-Hannon

Center for Psychological Growth and Resilience, LLC

Key Points

  1. Applying DBT skills and developing healthy new habits takes time and practice. It’s important for clients to understand this, and to know setbacks are to be expected.
  2. Mindfulness is key to implementing DBT skills. It can be increased by the use of phone timers, post-it notes, and other reminders to do self-check-ins and apply relevant skills.
  3. Family dynamics and other old patterns can be barriers to therapeutic change. The FAST and DEAR MAN skills are effective for setting boundaries and fostering assertiveness.
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While it may sound like Jackie implemented a lot of skills, her treatment took place over many months, and there was a significant amount of problem-solving when they didn’t work. It was important to remind her that treatment is not linear and creating new habits takes plenty of time. She experienced regular setbacks, struggles, and obstacles just as anyone would. By far the biggest hurdles for her to jump were mindlessness and old patterning.

Mindlessness

Mindlessness is lack of intentional awareness, not putting much effort into paying attention. Jackie, as with all newcomers to DBT and mindfulness, struggled at first to focus her attention in moments when she most needed to implement skills.

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