The therapeutic relationship doesn’t come first when treating a new client

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When I start work with new clients, I’m very mindful of working to help them get the changes they want as soon as they can. I want them to get their money’s worth from treatment.

People come to therapy because they want things to be different. There is something that is making them unhappy or uncomfortable. My job, as I see it, is to help clients figure out what they need to do/think differently and help them get there as soon as they can.

I ...

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Another fascinating insight from DBT founder Marsha Linehan

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There is not a day that goes by that I don’t think, “Thank goodness for Marsha Linehan,” the developer of Dialectical Behavior Therapy (DBT). She has taught us so many ways to increase skillful behavior.

It happened again recently while I was attending the Latin American Conference on DBT in Argentina.

After missing her international flight from Seattle due to weather, her presentation was rescheduled for 8 a.m. the following day. I value hearing Marsha speak, but I didn’t make it to ...

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How DBT helps when the client has something difficult to tell the therapist

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Previously, I’ve written about the framework DBT provides to help therapists address therapy interfering behaviors in session with their clients.

But what if the client feels the therapist is engaging in behaviors that interfere with treatment? How do you have these conversations? DBT offers some guidelines about this as well. (Frankly, these strategies may help you have courageous conversations with ANYONE important in your life.)

1. Remember: In DBT the therapist and client are considered to have a relationship between equals. ...

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Courageous conversations about Therapy Interfering Behaviors

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In Dialectical Behavior Therapy, we use the construct of Therapy Interfering Behaviors (TIBs) to discuss issues that get in the way of us providing, or the client receiving, expert DBT treatment. Identifying TIBs is one thing; addressing them is another.
How do you define a Therapy Interfering Behavior? How do you conceptualize it? How do you phrase it in conversation? When do you talk about it? Where do you start? Here are some recommendations

  1. Do some prep work. This is not a ...
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