DBT Dialectical Interventions

Greetings, and welcome to the sixth video in this series on dialectical thinking. In the previous video, we learned a simple technique to change problematic thoughts: thought, opposite, middle. In this video, we will learn some more strategies to hone our dialectical skills and especially to apply them to trauma work. So let’s get started.

So As we know, one of the hall--, hallmark symptoms of PTSD is disproportionate self-blame. Self-blame is also one of the main factors which causes PTSD to persist. It’s for fascinating psychological reasons that we won’t get into here. But regardless, “responsibility pie” is an intervention to figure out how much a client blames different people for their trauma, including themselves. So It’s a simple intervention, and this is how it works. So, you help the client make a simple pie chart. Each piece of the pie represents how much each person was responsible for the trauma, obviously, from the client’s perspective.

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2016). Trauma-focused CBT for children and adolescents: Treatment applications. Guilford Press.,Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises for overcoming trauma and post-traumatic stress disorder. New Harbinger Publications.

So Not surprisingly, clients with a high level of self-blame will tend to give themselves the biggest piece of the pie or, at the very least, a piece that is much bigger than it probably should be. SoAt this point, the, the only purpose of the intervention so far is to figure out how much self-blame the client is giving themselves. So once a responsibility pie has been created, you can use a variety of interventions to help the clients self-reflect on how they’ve divvied up the pie. In other words, how they’ve distributed responsibility for the trauma to different people, including and especially themselves.

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2016). Trauma-focused CBT for children and adolescents: Treatment applications. Guilford Press.,Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises for overcoming trauma and post-traumatic stress disorder. New Harbinger Publications.