Dialectical Behavior Therapy for Wellness and Recovery

ANDREW BEIN, PhD, LCSW, has nearly thirty years of experience as a clinician, consultant, trainer, and researcher. He is a Full Professor with the Division of Social Work at California State University, Sacramento.

Foreword by Alfred W. Kaszniak ix

Preface xiii

Chapter One Applying Dialectical Behavior Therapy: Toward Access for Diverse Client Needs 1

Gifts of Dialectical Behavior Therapy 1

Chapter Two Emotion Regulation and Resilience: Developing Wise Mind 15

Emotion Regulation Strategies and Helping Framework 17

The Skillfulness of Intention: Am I in Wise Mind? 21

The Intention of Self-Compassion 27

Mindfulness of the Moment 35

Responding to Emotions in the Moment 44

Expanding the Moment: Resilience Building and the Bigger Picture 58

Validation and Acceptance to Support Client Change 70

Chapter Three Applying DBT to Mental Health and Substance Abuse Recovery 77

Overview of Issues 77

Practicing Mental Health Recovery in DBT-WR 79

Motivational Interviewing 99

Substance Abuse Recovery 103

Chapter Four Accounting for Trauma 113

Overview 113

Trauma to Normalize Emotion Regulation Challenges 115

Neuroscience Engenders Hope and Interest 116

Acknowledgment of Trauma and Extreme Stress Validates Clients 119

Being Mindful of Trauma in the Here-and-Now 121

Resilient Zone 123

Chapter Five Clinician's Use-of-Self: Foundation for Effective Practice 129

Strong Back, Soft Front 130

Use-of-Self Interface With Radical Acceptance 133

Intention and Mindfulness Fueling Effective Practice 136

Use-of-Self With Challenging Clients and Circumstances 139

Responding to Diversity as Opportunity, Not as Nuisance 142

Practitioner Non defensiveness 145

Language of Invitation 147

Use-of-Self Summary 148

Chapter Six Lessons and Activities: Dialectical Behavior Therapy for Wellness and Recovery 149

Principles for Using Lessons 149

Improve the Moment: Language and Meaning 151

Session Structure and Flow 153

Homework 155

Approaching the Lessons With a Light-Hearted Spirit 156

Lesson 1: Mindfulness and the Brain 157

Lesson 2: Facing Emotions and Thoughts and Improving the Moment 163

Lesson 3: Dealing With Judgments 169

Lesson 4: Expanding the Moment 173

Lesson 5: Dealing With Difficult Times 177

Lesson 6: Opposite Action 183

Lesson 7: Not Getting Stuck Doing the Usual 188

Exercise 8: Friend to Self: Willing Participation and Mindful Walking 193

Lesson 9: Primary and Secondary Emotions 198

Lesson 10: Friend to Self: Doing What Is Needed and Self-Care 201

Lesson 11: Getting Grounded: Finding Wellness Amidst Distress, Anxiety, and Worry 206

Lesson 12: Finding the Zone: Moving From Suffering to Balance 212

Lesson13: Self-Nurturance and Joy 216

Lesson14: Effective Speech and Telling the Truth 219

Lesson 15: Inspiring the World With Our Courage and Path 223

References 227

Appendix 237

Log for Daily Living 238

Wise Mind: Handout/Presentation Version 240

Acknowledgments 241

About the Author 243

Author Index 245

Subject Index 247