Dialectical Behavior Therapy Case Study

Treatment Goals

Katie’s goals were split into three areas and it was devised to be consistent with the ideology of Dialectical Behavior Therapy. Katie has a history of trauma, reports flashbacks and intrusive thoughts, and displays aggressive behaviors. She struggles with verbally aggressive behaviors and frequently uses profanity toward members in the home. Katie has a history of property destruction. For this goal to be met, Katie would need to practice identified coping skills 2-3 times per week as self-reported, reported by parent and/or observed by therapist. Therapist will teach Katie how to use bilateral movements, role-play, modeling, and coaching to assist her with developing accessible coping strategies. Clinician will support

When triggered, she flees from stressors, resulting in unsafe behaviors. Katie struggles with contacting and leaving with individuals the family does not know. This also keeps her from adhering to legally required curfews. Katie will follow identified safety plan to maintain stability in the home as observed. The therapist will develop a meaningful and personalized safety plan that will consist of reinforcement for utilizing the identified safety plan. Kate will verbally differentiate safe versus unsafe behaviors as self-reported and observed. The use of psycho-education and role-play of scenarios will support the client in recognizing risky behaviors and safe and unsafe social behaviors including the use of social media. Mother and adults in the home will practice active parenting around safety planning as self-reported and observed. Again, psycho-education and parent coaching that are trauma informed to increase closeness with the child. These techniques will include: emotional validation, emotion coaching, reflective listening will be emphasized to decrease reactivity and trauma echoes. Education regarding the complexity of blended family issues and problem solving in the home. Katie will attend school 5 out of 5 opportunities as reported by the school and observed. The therapist will assist the mother in creating behavioral incentives to promote increased attendance. The clinician will collaborate

Katie will identify positive self-attributes at least 3 times per week for 4 consecutive weeks as self-reported, reported by family and observed. Psycho-education will be utilized to work on healthy identity and self-concept, internal scripting and self-talk and facilitate exercises regarding internalization of strengths. Katie will verbally identify healthy choices when prompted for 4 consecutive weeks, as reported by family and observed. Sessions in the community will guide the client in making appropriate choices. Katie will identify healthy boundaries in social relationships when prompted for 4 consecutive weeks as self-reported, reported by family and observed. Assignments on boundaries will be aid the client in establishing positive boundaries with others especially during times of crises for her peers and on social media. This information was presented to Katie and her family to review and agree to because the client needs to accept the pros and cons of treatment (Sachs & Rush, 2003). The client must view the burden of treatment as an improvement to the quality of their life; conversely, patients with bipolar disorder generally are noncompliant with therapy (Sachs & Rush, 2003). Some of the contributing factors may be their drug use, relapse, cycling of episodes, and even treatment ineffectiveness (Sachs & Rush, 2003). For this reason, a contract is necessary because it makes the client