Читать книгу DBT For Dummies - Gillian Galen - Страница 38

The skills of DBT are of little value unless they are put to use in the moment that they are needed. When times are calm and emotions are better regulated, it’s easy to see how the skills can be useful, and many patients can explain how the skills would work in their day-to-day life. However, in times of emotional turmoil, the more familiar, often maladaptive, behaviors are the ones that tend to show up first. When the urges to self-harm or use substances show up, the more intense the emotions, the more likely the unskilled person is to use these old forms of dealing with the urges.

Dr. Linehan recognized that life’s most challenging problems tended not to happen when patients were in therapy. They could happen at any time, day or night. She emphasized the importance of intersession coaching to help patients generalize the skills they had learned in the skills training group to their everyday life. The duration of a skills-coaching call is intended to be a brief call of typically no more than 15 minutes to offer patients support and ideas to deal with an in-the-moment situation.

One of the major concerns that new therapists worry about is that spending time out of session on the phone with their patients might reinforce life-threatening behavior. In other words, they worry that if patients feels supported during a call when they are feeling suicidal, it’s possible that they may then express more suicidal thoughts to be able to speak to their therapists more frequently. Therapists are taught how to deal with this eventuality (see Chapter 14).