DBT. Recovery. CBT/Behaviourism.

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DBT. Recovery. CBT/Behaviourism.

• Common Core Philosophy

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Hope.

• Central to Recovery.
• DBT the life worth living.
• CBT. Cognition and behaviour can change. You can
  choose.

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Working with strengths.All look at the whole
person, not the pathology.

• Recovery regaining or developing valued roles.
• DBT. Encouraging mastery.
• CBT. Focus on behaviour to increase what the
  person can do as opposed to what they do wrong.

4
Normalisation.

• Recovery. Building a life outside the services
  employment focus.
• DBT. Biopsychosocial model applies to some degree
  to everyone.
• CBT. We all have dysfunctional thinking patterns
  and challenging behaviours sometimes.

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Common humanity, common vulnerability.

• Recovery. Trainers devise their own WRAP plans.
  Encouragement of employment of those who have
  recovered in the services (experts by
  experience).
• DBT. Therapists note own therapy intefering
  behaviours, dialectical dilemmas and emotion
  mind.
• CBT. Therapists monitor the effect of
  challenging behaviour on their own arousal
  systems and thought patterns, and sidestep
  reproducing the pattern or responding from the
  raised state of arousal.

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Collaboration.

• Recovery service user sets the agenda.
• DBT. Client must agree to work on reducing self
  harm as a first priority, but the life worth
  living is their own vision.
• CBT goals of therapy are arrived at
  collaboratively.

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Accepting reality

• Recovery. The concept of the turning point means
  the point at which the individual recognises
  whatever limitations are imposed by their
  problems, and accepts what has happened in the
  past this makes taking ownership of their
  future possible.
• DBT. Acceptance is a core concept.
• CBT. Individual needs to be prepared to take
  responsibility for change.Work on changing whats
  changeable - no point challenging an
  unchallengeable thought.

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Self Monitoring

• Recovery PIP.Identify wellness, and then
  triggers and early warning signs for relapse.
  Relapse is a normal part of recovery.
• DBT Diary cards.Chain analysis.
• CBT Thought Diaries.

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Response to Risk and challenge.

• Recovery. PIP individual responsibility for
  maintaining wellness and specifying what should
  happen in case of breakdown.
• DBT. Skills training, featuring mindfulness, to
  master action urges.
• CBT. Specifying behaviours to increase and
  reinforcing them is the most efficient way to
  decrease challenging behaviours.

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Idea of Balance and Finding a Middle Way

• Recovery. Balance between learning to live with
  symptoms and a relapsing condition, and making
  the most of life.
• DBT. Always looking for the dialectic, and for
  the wisdom in both poles while seeking a way
  through. There is no one right way the process
  carries on.
• Behavioural approach to challenging behaviour
  balancing the obvious, behaviours to decrease
  with emphasis on behaviours to increase.
• CBT you can choose the most helpful way to think
  about things.

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Unique features

• Recovery. Service users, not professionals, in
  charge.
• DBT. Skills training and mindfulness.
• CBT. Individual formulation of difficulties.
• However the similarities are more striking and
  numerous than the differences.

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Common Core Philosophy.

• Hope
• Working with strengths.
• Normalisation.
• Common humanity, common vulnerability.
• Collaboration.
• Accepting reality.
• Idea of Balance and Finding a Middle Way.
• Proactive, collaborative response to risk and
  challenge.

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Implications for staff role.

• Staff need to hold hope and vision for the
  individual even when they cannot yet see it.
• Staff need to concentrate their efforts on
  identifying and working with the persons
  strengths and interests.
• Staff need to see the person as they might fit
  into society to help them maximise their
  prospects. They need to listen to the person and
  take seriously what they say.
• Staff need to be aware of and manage their own
  emotional reactions.
• Staff need to develop their skill in working
  collaboratively.
• Staff have a vital role in enabling the person to
  accept what has happened and its consequences,
  and take responsibility for continuing problems.
• Staff must keep in mind the need to balance
  working with strengths with realistic support
  with problems.
• In managing risk, staff need to seek the full
  collaboration of the service user.