Dialectical Behavior Therapy for Wellness and Recovery: Interventions and Activities for Diverse Client Needs

Praise for Dialectical Behavior Therapy for Wellness and Recovery "This book offers a remarkable gift for the diverse clients in our agency struggling with co-occurring mental health and substance abuse disorders. The sessions are structured in an easy-to-use format that makes DBT much more accessible than any curriculum that I have seen before. Dialectical Behavior Therapy for Wellness and Recovery is a testament to Dr. Bein's dedication to improving the lives of clients and clinicians and to the far-reaching impacts of mindfulness in serving those with diverse needs." —Karen Larsen, MFT, Director of Behavioral Health, CommuniCare Health Centers, Davis, California "Finally, a book on DBT that goes beyond tradition, helping practitioners apply the unique insights and skills of the approach to a wider range of people and presenting problems. Dr. Bein shows how honoring the client's perspective can take DBT to a new level. Well written, concise, and engaging. Bravo." —Scott D. Miller, PhD, Director, International Center for Clinical Excellence; Cummings Professor, Department of Behavioral Health, Arizona State University "I highly recommend this book for its accessible, practical, and experience-based approach, which will equip practitioners with the skills to help their clients engage in treatment and find their own answers to vital questions related to their personal recovery." —Mike Slade, PhD, Clinical Psychologist; Professor, Institute of Psychiatry, King's College London; author of Personal Recovery and Mental Illness A hands-on and clinically rich approach to integrating dialectical behavior therapy with highly resistant clients Initially introduced for treating borderline personality disorder, dialectical behavior therapy (DBT) is now recognized as a successful treatment for a variety of other mental illnesses, particularly those distinguished by emotional instability. Dialectical Behavior Therapy for Wellness and Recovery presents unique and pragmatic approaches designed for the present-day realities of many mental health practitioners and their diverse clients. This unique volume presents empirically supported lessons for wellness and recovery in: Mindfulness and the brain Facing emotions and thoughts Dealing with judgments Dealing with difficult times Finding wellness amidst distress, anxiety, and worry Moving from suffering to balance Requiring no previous experience or training in DBT in order to use its techniques, Dialectical Behavior Therapy for Wellness and Recovery explores proven methods for assisting highly resistant clients with a history of treatment failure to experience lasting behavioral change.

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 Nondefensiveness 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 Diffi cult 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

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.