Category Archives: Adult DBT Programs

How DBT Can Help You and Your Family

Posted March 25, 2019

Mental illness is not a light matter. It takes a toll on everyone involved. If you or a loved one are experiencing signs of mental illness, it’s important to explain them to your doctor. As mental illness becomes more understood, there are a lot of treatments available to help individuals carry on a normal, healthy life. One solution is dialectical behavior therapy, which is a specific version of cognitive behavioral therapy. The word “dialectical” comes into play because, during therapy, opposite forces such as acceptance and change are brought into balance. Continue reading

8 TIPS to Help Clients Do Homework

Posted June 6, 2018

Dr. Lane P.: Hi, I’m Dr. Lane Pederson. One of the most common questions I get from participants in my seminars is, How do I get clients to do homework? In this short video, I’m going to share with you eight tips that I find to be very effective. Continue reading

Relaxation Script for Pain

Posted December 13, 2017

Studies indicate that up to 50% of individuals diagnosed with chronic pain will also meet the DSM-IV-TR diagnostic criteria for anxiety. This is because many individuals who experience chronic pain describe anxiety and pain distress as a circular fashion: pain contributing to stress, which leads to muscle tension, which leads to more pain. It is important to practice relaxation strategies to cope with anxiety which will release tension in the body. You will find one example of a relaxation script below. In addition, use your mindfulness skills to pay attention to your body’s needs and shift the relaxation script as needed.

Breathing and Body Relaxation Script:

  • Begin by resting your body in a comfortable position. You may close your eyes, or if you are more comfortable keeping them open, stare at a fixed focal point in the room. Start grounding your awareness into your body. Feel your feet firmly meeting the floor, your back supporting you in your chair.
  • Once you have physically grounded yourself, slowly bring your attention to your breath. Notice the patterns of your breathing- the inhalation, pause, and exhalation.
  • Observe the rise and fall of your belly as you are breathing. If you notice that you are breathing from the chest, work to slow your breathing down, with slower and deeper breaths from your diaphragm. Allow for a few more rotations of this breath, going deeper and deeper into your core.
  • The goal of this breathing exercise is target a slower breath, a soothing breath. Perhaps counting allows you to pace your breathing. Try this experience, perhaps starting with intervals of 4 seconds.
    • Inhale, 2, 3, 4. Pause, 2, 3, 4. Exhale, 2, 3, 4. Inhale, 2, 3, 4. Pause, 2, 3, 4. Exhale, 2, 3, 4.
  • Repeat for a few more rotations.
  • It is natural for distractions to pop up in your mind. If you observe a distraction, identify it as just a thought and redirect your attention to your breathing.
    • Inhale, 2, 3, 4. Pause, 2, 3, 4. Exhale, 2, 3, 4.
  • Continue this breathing until you have found a natural rhythm of inhalations and exhalations that work for your body today.
  • Continuing to move with this rhythm, consider the idea of releasing tension with your exhalation as we expand into meditation with the breath. Feel yourself working to inhale calming energy, and exhaling muscle tension.
    • Inhale calm, 2, 3, 4. Pause, 2, 3, 4. Exhale tension, 2, 3, 4. Inhale calm, 2, 3, 4. Pause, 2, 3, 4. Exhale tension, 2, 3, 4. Imagine your body slowly releasing all of the built up tension.
  • As you work through your muscle groups, observe the experience of feeling lighter in your muscles are you work to cleanse your body of the tension.
    • Inhale calm, 2, 3, 4. Pause, 2, 3, 4. Exhale tension, 2, 3, 4.
  • Continue this process for as long as you find meaningful for you. When you are ready, you may begin the process of orienting yourself back to your surroundings. Feel your back against the chair, your legs against the chair, your feet resting on the ground. When you are ready, you may start to shift your body and prepare to move on to the next part of your day. Remember that you can return to this place, to ground yourself and release tension in your body, at any time you choose.

Asking for Help With Pain

Posted November 21, 2017

It can be challenging for individuals with chronic conditions to find the balance when asking for help. Many people have experienced barriers with everyday household activities and responsibilities as well as occasions of cancelling plans due to pain. It is common for individuals to feel like they will upset their support system by asking for help.  This leads many people to keep their needs to themselves. It can be easy to think that other people will automatically know what you need, and frustrations can result when they don’t get it.

Even though it may feel this way, keep in mind that we don’t know what other people are thinking.  Other people cannot read your mind to know what you need. It is appropriate to ask for help, and doing so builds self-respect. Use this idea as motivation to prepare and reach out

  • Start by identifying your different support needs. This includes emotional and physical needs.
  • The clearer and more specific you are, the better.
  • Communicate with your supports ahead of time. Ask them what kind of help they are willing to offer. For some, it may be help with chores like carrying laundry. For others, it may be help with getting to appointments or providing emotional support during challenging times.
  • Make sure to reinforce others for jumping in.

It may feel challenging in the moment to follow up and ask for help. Remember that your supports have shared with you what they feel comfortable with, and to trust their word and intention with what they offered. Use mindfulness to work on balancing the acceptance of help from others with the things you can do independently to enhance your quality of life.

5 Things to Think About When Working With Integrated Dual Disorder Clients

Posted October 19, 2017
  1. A basic truth of behavioral health interventions is that no two clients are alike.
    It is important to remember this as we do our work and it is especially vital to keep in mind with the complication of two significant behavioral disorders. How a client’s chemical health and mental health issues interact, impact daily functioning, affect willingness and even abilities to participate in therapy, is a very individual thing.
  2. Another basic truth is that for all clients, ‘perception is reality.’
    This is important in IDD treatment since mental health symptoms and chemical use (and the effects of long-term use) have real consequences for how a client might perceive their world.
  3. A harsh truth of therapy is that change is difficult, time consuming, and at times, difficult to notice.
    For IDD clients, there can be a significantly higher degree of difficulty paired with a lower level of skills. This can make the process even harder, longer, and more difficult to experience a sense of success.
  4. Acceptance and support are key additive factors to success in therapy.
    IDD clients tend to have heavily damaged, if not absent, systems of support and acceptance.
    There is a drive from payers to identify the primary diagnosis as the target for treatment.
  5. IDD clients have two significant primary diagnoses in all cases, and the majority have significant issues across what used to be the five axis’ of diagnosis. We have to attend to all significant issues.
    ~Steven Girardeau, PsyD, LP, Director of Clinical Services at MHS

At what moment does change happen, and how can clients notice it?

Posted April 17, 2017

Check out this Pain-and-Change1.pdf from CBT for Chronic Pain and Psychological Well-Being by MHS owner, Dr. Mark Carlson. Buy it on Amazon today! Many concepts from Dr. Carlson’s manual are used within the Thrive Program for Psychological Well-Being and Chronic Pain at MHS. Schedule an intake appointment for yourself or your client today!

CBT for Chronic Pain and Psychological Well-Being

10 Days to a 10-Minute Meditation Practice

Posted March 23, 2017

Pain 1Developing a Meditation Practice Can Seem Impossible…Until You Discover How Doable It Can Be! Taken from Dr. Lane Pederson’s new second edition of The Expanded Dialectical Behavior Therapy Skills Training Manual, these free handouts explain a step-wise and doable method for bringing a brief meditation practice to your and your clients’ lives. Start today!

Click HERE to view the handouts.

Mindfulness Exercises

Posted March 16, 2017

DBT Manual 2Mindfulness is one of the pillars of DBT and has become increasingly important across contemporary therapies. Yet many therapists are at a loss for examples to suggest and use with their clients. Taken from Dr. Lane Pederson’s new second edition of The Expanded Dialectical Behavior Therapy Skills Training Manual, enjoy this free handout you can use with any client looking for mindfulness exercises…and remember, mindfulness is not what you’re doing, but how you are attending to what you’re doing!

VIEW HANDOUT HERE

5 DBT Skills to Enjoy the Holidays

Posted November 18, 2015

Finding yourself or your clients stressed out and dreading the holidays? While many struggle through the holidays, that doesn’t mean we are powerless to use our skills. Building on our 5 skills to survive the holidays blog, we offer 5 more skills to actually enjoy the season. Here they are:

1. Build Positive Experience (BPE):
BPE starts with being mindful of positive events that are happening all around us. Often we miss opportunities for fun or connection because we are lost in our problems and worries. Time to awaken and take advantage of positives that are possible now. Listen to favorite holiday music, watch time-honored movies, and commit yourself to investing in the season. Make sure to schedule times to get out and about to get-togethers, community functions, services, and other events that pop up during the season. BPE takes investment, planning, follow-through, and sometimes a dose of opposite-to-emotion too!

2. Attend to Relationships (A2R):
A2R is a specialized type of BPE. Relationships are like plants in that they need to be watered or they wither. The holidays are the perfect time to send cards, pictures, or to write a meaningful note or letter. Connect by phone, Skype, or in person if possible. Take extra time to let others know that they matter to you.

3. Contributing:
Surprise a friend, loved one, or co-workers with cookies or another treat. Participate in parties and events in whatever way you can…even your presence is contributing. If you are able, consider volunteering your time with any organization that helps those less fortunate, or take time to set aside and donate items you no longer need. Support an organization like Toys for Tots or volunteer to be a Salvation Army bell ringer. Whenever you can, think about how you can give, which is a true meaning of the season.

4. Self-Soothe:
Get into your senses. The holidays are filled with sights, sounds, smells, and tastes that are pleasing to our senses. Connect mindfully to these moments, and allow yourself to relax into what the holidays have to offer.

5. Participate:
Participate is a core mindfulness skill, and it means fully immersing yourself in what you are doing in the moment. Truly inhabit each experience with your full self, gently letting go of distractions to get back to being with what you are doing and who you are with during this season. Remember that we can participate in stress and misery, or in the many opportunities for joy that the season can offer us.

5 DBT Skills for Surviving the Holidays

Posted November 10, 2015

Holidays can be a time of joy or misery. While we cannot control the world around us, or make reality unfold according to our preferences, we can practice our skills to navigate challenges and focus on what is most important to us…thereby influencing our mood for the better. Create a more stress free holiday season for yourself and others with the following skills. And stay tuned for the next email on 5 skills to not just survive, but to enjoy the holidays!

1. MINDFULNESS
Mindfulness is about paying attention to the present moment, on purpose, with an open heart and nonjudgmental stance. It is about directing what we want to focus on and when based on our wisdom and what will work. During the holidays our minds get hijacked by worries about families, get-togethers, gifts, and balancing the competing pressures of the season. The remedy is to slow down and focus on this moment, taking one thing at a time, and doing exactly what is needed (which might be just being present and not doing a thing!). We can only influence the future through this moment, so live it as effectively as you can. Also remember to take time to practice breathing, imagery, or to simply contemplate the true meaning(s) of the season.

2. OPPOSITE TO EMOTION (O2E)
The holiday season might mean that you have a lot to do. When pressure builds, procrastination and avoidance can grow. Avoidance behaviors get reinforced by what we call negative reinforcement…there is temporary relief that comes with avoiding any activity that causes stress. Step out of this trap by acting opposite to procrastination and avoidance behaviors by doing tasks and activities that need attention…take the first step and throw yourself into it. Also, don’t be afraid to balance this strategy by simplifying and letting go of task and activities that are truly non-essential.

3. PLEASED
The PLEASED skills are all about self-care. Halloween candy is still around, and more holiday goodies are on the way. Unfortunately, many of us cope with stress by indulging in the excesses of the season. It feels good in the moment, but probably works against our larger goals. This is the time to be more mindful of eating healthy, balanced food, getting more movement in our day, and improving the amount and quality of our sleep. We like to think that self-care can wait until January 1, but really the time for it is today. An increase in these skills will help make the holidays more joyful with less stress. We all do better when we feel better!

4. RADICAL ACCEPTANCE
This skill means letting go of fighting reality. When you accept and give up the fight, then you free up your mental and emotional resources to be as effective as you can. Almost by definition, needing to use acceptance means that the situation you are choosing to accept is not your preference and you do not like it. For a greater good you might need to see your in-laws (or your own family), or go to that holiday or office get-together, or make some kind of compromise. Practicing an attitude of acceptance with life’s difficulties is a nice alternative to fighting every battle and making yourself suffer over what is. That is not to say give up and give in. Sometimes we do need to set boundaries or solve a problem…but if you need to do that, you will still be more effective if you start with acceptance.

5. WILLINGNESS
This skill is the opposite of trying to control everything or take a my way or the highway approach to others and life. Being willful limits our options and forces everyone into corners. Maybe it does not have to be your way! When appropriate, learn to let go and go with the flow. Be willing to do whatever is necessary to accomplish a goal or to contribute to a get-together or another person. Let go of your preconceived notions of how you think a situation should be and practice flexibility. Holidays can make us feel out of control, which we sometimes react to by trying to control everything. People who practice willingness learn to bend so they don’t break!

MHS wishes you, your friends and family, and your clients a joyful holiday season!