- Dialectical Behavioral Therapy Pdf
- What Is Dialectical Behavioral Therapy
- 27 Urge Surfing Dialectical Behavioral Training Certification
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How do you tend to respond to a powerful urge? Are there certain experiences that show up more frequently for you? Are there particular experiences that you attempt to avoid? Let’s be proactive by getting curious and mindful of these urges and learn how urge surfing and Acceptance and Commitment Therapy can help.
What urges come up for you when you:
- get home from work?
- wake up in the morning?
- get rejected?
- when a relationship ends?
- are faced with a challenge?
- feel bored?
- feel lonely?
- have a need you want to express?
- feel criticized?
What exactly is an urge?
Urges are very interesting to think about. An urge is a strong desire or craving to act impulsively and out of habit. An urge occurs right before a behavior and is experienced as an intense physical and emotional experience. Urges get triggered by an event, a thought, feeling, memory, or image and pull us towards automatic ways of responding. Urges can feel like waves, they rise in intensity and tug and pull us towards using old behaviors that may provide us a temporary relief, but often lead to negative consequences in the long run. Rather than struggling and fighting an urge we can ride it by staying present and mindful, noticing the moment it peaks and the moment it crashes.
For example an individual may have developed the urge to log on to Facebook or reach out to someone as soon as he/she experiences any sign of loneliness or boredom. Others may have gotten conditioned to have a drink right after work or in social situations, creating a link between a common uncomfortable experience and a behavior that has temporarily relieved the discomfort. Now they continue to use the same old behavior to avoid feelings of anxiety, loneliness, boredom, or distress. They continued to reinforce a bad habit as a coping response to challenging situations and experiences.
Using a short-term solution to resolve long-term struggles will only increase the distress in the long run. Acceptance and Commitment Therapy (ACT) refers to this outcome as “secondary pain”. The more that we use old response styles, the more that our pain grows. Rather than fighting our experiences lets practice staying with our experiences, befriending them, and getting curious about them by using urge surfing.
What is Urge Surfing?
Urge surfing is coined by Alan Marlatt in preventing relapses among patients recovering from drug addiction. Urge surfing is not only used with addictions, but with any coping behavior that results in a short-term decrease in suffering, but exacerbates our pain in the long run. The principle advocates that fighting the craving is futile. The urge is seen as a water force such as a wave or a waterfall that we can’t control. In fact, fighting them could only feed them. Instead, we can observe the waterfall or surf the wave and watch it go right past. Urge surfing is an empowering tool because it trains us to stay mindful of our urges and impulses so that we have more control over the behaviors we choose.
1. Identify the Physical Sensation in the Body
Stop for a few minutes and be mindful of your physical responses to your urge. You can close your eyes or simply sit in a comfortable position. Pinpoint which specific body part is being affected. Where in your body does this sensation feel most intense? Is it your stomach? Your gut? In your chest? Your jaw?
2. Focus on the Sensations
Now, having that specific body part in mind explore the sensations related to it. For instance, if it is the head, do you feel a bit dizzy? Is there pain? Does it feel warm? Is it more on the right side? If you feel the need to focus on other body parts, you may do so following the same process.
3. Notice Breathing
For 1-2 minutes, be mindful of your breathing pattern. It may be a good idea to think of a body part specifically related to breathing such as your diaphragm, lungs, or nose. It is better to inhale through the nose and slowly exhale through the mouth.
4. Refocus on Your Body
After noticing your breathing, gradually refocus on the body part that has been affected by the urge. Visualize how each breath lessens the weight, pain, or distinctive sensations. It may be helpful to imagine each cleansing inhalation as white light rejuvenating your body and each exhalation a dark smoke that you are happy to get rid of. Pay attention to how these processes change how you feel.
5. Stay Curious and Present
Think of your physical and psychological sensations as a wave that you can successfully ride out with your breathing. See if you can gently make space for the experience. Send loving kindness and compassion to the deep longing and yearning that is showing up for you, if you’re your mind starts selling you stories or distracting you, just simply notice the mind and the thoughts that it pops up and return to your breath and the physical sensations. Anticipate it’s coming and breathe it in as it peaks and exhale as you think of the urge crashing down. Then after 2 minutes or longer, congratulate yourself for a surf well done!
By recognizing how urges pull us towards old avoidant coping strategies, we can have the effective tools to choose behaviors that benefit us in the long run and bring us closer towards our values. By focusing on who we truly want to be in our life and what we want to stand for, we can learn how to successfully surf our urges.
PRACTICE MINDFULNESS:
Training our minds to stay curious and open with our urges will make us stronger not only for specific addictions, but in our overall existence as well. Practicing mindfulness can help us train our brain to stay more present and observe our internal experiences and discomfort without having to act on it. The more we can sit and tolerate our uncomfortable experiences and urges the less influence they have over our behaviors. When we practice breathing and staying present with our discomfort, we can become more able to ride out the cravings that lead to damaging consequences and engage in more effective and consistent behaviors.
LET IT PASS:
Urges are temporary. Therefore, you don’t have to act in them for them to change and morph. Whenever you feel the impulse or have the nagging thought, bring your attention to your breathing and bodily sensations and stay curious and present with your present moment experiences. Keep in mind that this doesn’t mean that you should suppress your urges, but that staying mindful of your urges increases your behavioral choices. It is understandably challenging specially in the beginning. However, after practicing this skill your urges will no longer act as barriers or be your enemies, instead your urges will inform you about what matters to you and what kind of person you want to be. If we learn to get very curious about our urges and extend the moment when these impulses arise, we can start creating behavioral flexibility. By being aware of our reactions, we can better manage our actions and decisions.
CBT Tools to explore: CBT Questionnaires and Mindfulness Audio.
By Zainab Fazal, M.ADS, BCBA
bSci21 Contributing Writer
On June 22, 2015, I received a phone call from a staff at a local residential home serving adults with developmental disabilities. With a lot of excitement, she asked if I watched NBC Dateline the night before. Before I could answer, in even more excitement, she said, “that guy did that strategy you were talking about in class!”
Let me give you a little insight into what she was talking about. She was referring to the segment on NBC Dateline called “My kid would never do that: gun safety”, and the guy was Dr. Raymond Miltenberger.You can check out the segment here.
If you teach anyone, anything, behavior analysis has a secret to share with you. It’s the strategy the staff was talking about – Behavior Skills Training (BST). It is a method to teach students, staff, parents, and anyone else you are teaching a new skill. Dr. Miltenberger defines BST as “a procedure consisting of instruction, modeling, behavioral rehearsal, and feedback that is used to teach new behaviors or skills” (2004, p. 558). And that’s exactly what it is, a 4-step teaching strategy that works!
BST teaches a person what to do — that is, what behaviors to engage in under a particular circumstance.It allows for practice within the program so that the person can become fluent with the skills.It is an effective train-the-trainer procedure. And perhaps most importantly, can be individualized to each person. Sounds pretty good, doesn’t it?
Let’s break down each of the steps:
Instruction – Provide a description of the skill, its importance or rationale, and when and when not to use the skill. Repeat this step as necessary.
Modeling – Show your participant how to perform the skill. In-vivo modeling is recommended.
Rehearsal – Practice, practice, and practice! Allow the participant opportunities to practice the skill. Recent research suggests that participants should be able to practice in-situ. The trainer should record data on correct and incorrect responding during this step.
Feedback – The trainer should provide positive praise for correct responding and some form of corrective feedback for incorrect responses.
Some requirements before you can implement a BST program include: the person receiving the training must have the pre-requisite skills required for the behaviors you are teaching, the skill must include a chain of behaviors (a number of skills), and you must be able to role-play or video model the skills.
Dialectical Behavioral Therapy Pdf
In a Registered Behavior Technician training course I was providing, I used BST to teach various skills to participants. Any skill I was teaching that met the afore-mentioned requirements I taught using BST. Based on the feedback forms from eight cohorts, participants reported that they enjoyed and learned the most when they got to practice the skills being taught, and got immediate feedback.
Here’s an example of how it was used in the training. The skill was implementing preference assessments with clients.
Instructions were provided on why preference assessments are done, when and with whom to do them, how to use the data sheet, the materials required, and how to complete the assessment.
I modeled completing a preference assessment, using one of the course participants as my “client.”
Participants paired up and practiced administering the preference assessment with their colleagues.Participants were able to practice the skill as each preference assessment included 30 trials!
I went to each group and provided feedback on what each person was doing correctly and incorrectly.
What have been your experiences with Behavior Skills Training? Let us know in the comments below. Also, be sure to subscribe to bSci21 via email to receive the latest articles directly to your inbox!
What Is Dialectical Behavioral Therapy
Recommended Readings:
Johnson, B.M., Miltenberger, R.G., Egemo-Helm, K., Jostad, C. J., Flessner, C., & Gatheridge, B. (2005). Evaluation of behavioural skills training for teaching abduction-prevention skills to young children. Journal of Applied Behavior Analysis, 38, 67-78.
Miles, N.I., & Wilder, D.A. (2009). The effects of behavioral skills trainingon caregiver implementation of guided compliance. Journal of Applied Behavior Analysis, 42(2), 405-410.
Miltenberger, R. (2004). Behaviour Modification: principals and procedure (3rd ed.) Belmont, CA. Wadsworth Publishing.
Miltenberger, R.G., Flessner, C., Batheridge, B., Johnson, B., Satterlund, M., & Egemo, K. (2004). Evaluation of behavioural skills training procedures to prevent gun play in children. Journal of Applied Behavior Analysis, 37, 513-516.
Steward, K.K., Carr, J.E., & LeBlanc, L.A. (2007). Evaluation of family-implemented behavioural skills training for teaching social skills to a child with asperger’s disorder. Clinical Case Studies, 6, 252-262.
27 Urge Surfing Dialectical Behavioral Training Certification
Zainab Fazal, M.ADS, BCBA, began her career in the developmental disabilities field in 2002, and has dedicated her clinical work and research in the area of Applied Behaviour Analysis (ABA). She has worked for many years in assessing and developing comprehensive programs plans for children, youth, and adults with Autism Spectrum Disorders (ASD), learning disabilities, other developmental disabilities, behavioural challenges and mental health issues. Her recent work includes training front-line staff and teachers to use ABA in therapeutic and school settings, and has successfully trained individuals for the Registered Behaviour Technician credential with the Behaviour Analyst Certification Board. She is also an adjunct professor at Seneca College teaching ABA courses in the Behavioural Sciences program. Zainab is the founder and director of Phoenix Behaviour Services, a private practice in Toronto, Canada. You can follow her on twitter @Phoenix_ABA and reach her at zainab@pbxs.ca.