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

274 Pages·2013·2.55 MB·English

by  Andrew Bein

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Praise for Dialectical Behavior Therapy for
Wellness and Recovery: Interventions and
Activities for Diverse Client Needs
“It is exciting when a book comes along in the mental health fi eld that
both changes the way we think about our work and can be immediately
applied to our work in a practical way, and Andrew Bein’s book does just
that! As a mindfulness-oriented therapist in a busy university counseling
center, I am excited to start using this book in my work with clients, and
I know it will be a resource I will turn to again and again.”
Ronni Arensberg, PsyD, LP,
North Dakota State University Counseling Center
“Andrew Bein’s latest book brilliantly captures the essence of DBT and
integrates self-regulatory concepts that are key to healing trauma. The
practical exercises and monitoring tools are excellently designed and will
be helpful tools that will enhance recovery. This book will not only be
useful for clinicians but clients as well.”
Elaine Miller-Karas, LCSW; Executive Director
of the Trauma Resource Institute
“This is a thoughtful book that dares to venture into the uncharted ter-
ritory of rethinking treatment for persons diagnosed with personality
disorders based on the recovery paradigm. While DBT has always been
a respectful, and empowering, approach, Bein courageously challenges
some of the core assumptions upon which traditional psychotherapeutic
practice has been based in order to engage clients in a more collaborative
relationship that enables them to assume an active, and central, role in
their own recovery.”
Larry Davidson, PhD, Professor of Psychiatry,
Yale University School of Medicine
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“Like water on rock, Dr. Bein reshapes Dialectical Behavior Therapy with
a deepened appreciation for emotion regulation through mindfulness
practice. This practical and clearly presented model offers a much needed
treatment model for use in diverse settings. It is fi lled with simple, well-
constructed exercises and tools that make basic DBT principles more
accessible than ever before. Dialectical Behavior Therapy for Wellness and
Recovery is an invaluable contribution not only for therapy, but for quality
everyday living.”
Satsuki Ina, PhD, MFT; Director, Family Study Center;
Producer and Director, Children of the Camps
“Dr. Bein skillfully brings DBT, essential mindfulness practices, and skills-
building to the everyday world of therapists and clients. Andy presents
a cohesive and comprehensive model of integrative therapy that benefi ts
those willing to take on practices promoting growth and development
from the ground up.”
Edward Brown, Zen priest; Author; Tassajara Bread Book
“Dr. Bein’s thoughtful exploration of recovery reminds us that our clients
bring extraordinary strengths and life experience to the healing process.
The book’s concepts are presented in ways that are refreshing and new,
giving the clinician immediate clarity and sense of how to teach the mate-
rial. I plan to use DBT-WR for my next therapy group.”
Nancy White, LCSW, Private Practice;
Former DBT Group Leader, Kaiser Permanente
“Bein writes with authenticity and empathy, and, in his strong and soft
voice, concepts such as intention, self-compassion, mindfulness, and radi-
cal acceptance become not only of therapeutic value but a template for all
of us to live with presence and integrity.”
Shauna L. Smith, MSW, LMFT; Author, Making
Peace With Your Adult Children: A Guide to Family Healing;
Co-Founder, Therapists for Social Responsibility
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DIALECTICAL
BEHAVIOR THERAPY
FOR WELLNESS
AND RECOVERY
INTERVENTIONS AND ACTIVITIES
FOR DIVERSE CLIENT NEEDS
ANDREW BEIN
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Cover Image: ©iStockphoto.com/antishock
Cover design: Andrew Liefer
This book is printed on acid-free paper. ∞
Copyright © 2014 by John Wiley & Sons, Inc. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
All poems from LIMITLESS: NEW POEMS AND OTHER WRITINGS, copyright © 2009 by Danna Faulds, reproduced with
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Library of Congress Cataloging-in-Publication Data
Bein, Andrew M.
Dialectical behavior therapy for wellness and recovery : interventions and activities for diverse client needs /
Andrew Bein.
1 online resource.
Includes bibliographical references and index.
Description based on print version record and CIP data provided by publisher; resource not viewed.
ISBN 978-1-118-65333-3 (pbk) — ISBN 978-1-118-69061-1 (ebk) — ISBN 978-1-118-75997-4 (ebk)
1. Dialectical behavior therapy. 2. Mental health. 3. Clinical health psychology. I. Title.
RC489.B4
616.89’142—dc23
2013021305
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
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Contents
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
v
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vi Contents
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
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Contents vii
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
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