Category Archives: Integrated Dual Disorder (IDD) DBT

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.

Dr. Lane P.: Now, the first one is simply changing the name. I often times say the word “homework” when I talk to other therapists, but I rarely use that word when I’m working with clients. Instead, I might say, “Let’s do a task.” or “Let’s do an experiment.” Sounds kind of fun. Or I might simply say, “Let’s do our skill practice.” Sometimes, just changing the name can make all the difference. I’ve met so many clients who are just simply allergic to the word “homework”.

Dr. Lane P.: The second tip is really important. At the beginning of therapy, I always want to orient and educate my client about why homework is important to them. Why do they need to practice these skills, or why do they need to practice what we learned in session between sessions? An analogy I like to use is: To not practice between session is a lot like going to a personal trainer and talking about exercising but not actually exercising between those sessions. You’re just not going to reach your goals. It really is about plugging into what’s important to clients. Where do they want to be in life? What does recovery look like? What do they want to accomplish? You explicitly make that connection between skill practice and what it is that they desire, what they want.

Dr. Lane P.: The next idea is to always include clients in coming up with ideas for skills practice or tasks, or experiments. A lot of times, we therapists think that we need to generate all of the ideas, but our ideas for what might be helpful in terms of homework might not resonate with some of our clients. So, instead of doing homework to clients, I like to think about doing homework with clients and spending some time with having them come up with what they think would be helpful to do between sessions.

Dr. Lane P.: Which leads us to the next tip, which is: if you want clients to do homework or tasks or experiments between sessions, it’s good to initiate that skills practice in session. So for example, if I want a client to practice guided imagery, we’re going to practice guided imagery in session. If it’s important for a client to fill out an application before the next session, I might have the client just start to fill out the first parts of the application in the session with me. There’s something about breaking the ice in session with homework that gets clients motivated to complete and to finish it between sessions outside of our time together.

Dr. Lane P.: The next idea is to take one problem or opportunity and play it off of another. So for example, let’s say that you have a client who would like to walk to get some self care exercise in and the client also would like to socialize more to decrease isolation. You can set it up so if you don’t do one, you need to definitely commit to doing the other, so in this case, if the client didn’t go for the walk, he or she would definitely need to call a friend or to get out and socialize in one way or another. It’s a strategy that works really well.

Dr. Lane P.: Related to this strategy is another one which is simply making it a game. So, if you have a dichotomous choice like doing a fun activity versus taking care of a task at home, more of a responsibility, you can simply flip a coin. Heads you do one, tales you do the other. Or if you and the client have brainstormed lots of ideas, simply draw a cards. So, one skills practice might be associated with hearts, another one with clubs, another one with spades, and so on.

Dr. Lane P.: The seventh tip that I have is using the Premack principle. The Premack principle means that you make performing a high probability behavior contingent on performing the low probability behavior first. We sometimes call this grandma’s rule. Grandma’s rule is this. When you eat your vegetables, then you can go out and play. So with the Premack principle, let’s say I have a client who turns on the television every night. He or she really loves to watch evening television. I might say, “I want you to do your skills practice and then you can turn on the television.” Of course, many of us naturally do this Premack principle. You know, I need to return my emails and then I can surf the internet. It’s such a great strategy because the reinforcement is built-in.

Dr. Lane P.: And now, for the very last tip … and this one I think is the heaviest hitter. It is so important to simply schedule it. A lot of clients don’t complete their homework simply because they haven’t thought about where and when they’re going to complete it.

Dr. Lane P.: There was a study that happened many years ago and in this study, there was one group of people who agreed to do a task. They were committed to doing it. The second group of people were also committed, but that group also determined when and where they were going to complete the task. They completed it 80% more of the time. Hey, think about you or me. A lot of us don’t complete what would be important to do in life simply because we don’t write it down, we don’t commit to it in the schedule. So, taking a little bit of time to schedule homework is going to make all of the difference for your clients.

Dr. Lane P.: I hope these eight tips help you out a lot and, more importantly, help out your clients.

Dr. Lane P.: Thank you for joining me.

 

Emotions, Thoughts, and Situations That Trigger Addictive Behavior

Posted November 9, 2017

It can be challenging to identify and manage what triggers addictive behaviors. Understanding what sets off these behaviors and knowing which strategies and solutions for change are effective are essential in one’s recovery.

Enjoy this free handout on Emotions, Thoughts, and Situations That Trigger Addictive Behavior taken from Dr. Lane Pederson’s book The Expanded Dialectical Behavior Therapy Skills Training Manual.


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

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

Join Dr. Lane Pederson May 4th to learn about use of DBT for Co-Occurring Mental & Chemical Health Issues

Posted March 26, 2015

Lane IDD Book CoverDr. Pederson will present on the application of DBT to use with clients with mental and chemical health concerns later this spring.  This training will provide 6 CE hours, continental breakfast, and a free copy of DBT Skills Training For Integrated Dual Disorder Treatment Settings (a $29.99 value).  Click HERE to learn more about Integrated Dual Disorder DBT at MHS.

 

 

Dr. Steve Girardeau & Dr. Lane Pederson Present during Hazelden’s Clinical Connection April Sessions

Posted March 26, 2015

You are invited to join other health care professionals for a free forum to network, share, and discuss current hot topics. Hear from experts about new trends, research, and proven methodologies that are at the forefront of treating substance use and mental health disorders. Throughout April, Dr. Steve Girardeau and Dr. Lane Pederson, from MHS, will facilitate training and discussion around all-things DBT hosted by Hazelden.  For more information, click HERE!

DBT for Co-Occurring Mental and Chemical Health Issues Coming in May!

Posted February 19, 2015

Lane will conduct a MHS sponsored training on the use of DBT with Co-occurring Chemical and Mental Health Disorders at the Mall of America Learning Center on Monday, May 4th. Visit the Seminars and Training link for registration information.  A free copy of DBT Skills Training in Integrated Dual Disorder Treatment Settings is given to all who register.  Space is limited- sign up today!