DBT DBT Crisis Intervention and Safety 2 — Questions and Answers
Question 1: In DBT, what is the primary goal of 'safety planning'?
- To ensure therapists are safe during crisis calls
- To create a structured plan the client can use to manage suicidal crises and stay safe (Correct answer)
- To plan for hospitalization contingencies
- To document liability for the treatment team
Correct answer: To create a structured plan the client can use to manage suicidal crises and stay safe
Safety planning in DBT involves creating a personalized, step-by-step plan clients can follow during suicidal crises, including skills to use, people to contact, and crisis resources.
Question 2: What is 'means restriction counseling' in DBT safety planning?
- Limiting the client's access to therapy resources
- Discussing and reducing the client's access to lethal means for self-harm (Correct answer)
- Restricting the type of coping strategies a client can use
- Limiting phone coaching to certain hours
Correct answer: Discussing and reducing the client's access to lethal means for self-harm
Means restriction counseling involves working with clients and their support system to reduce access to lethal means (e.g., firearms, medications) to reduce suicide risk.
Question 3: What does DBT emphasize about hospitalization for suicidal clients?
- Hospitalization should always be the first response to suicidal ideation
- Hospitalization should be used judiciously as it can reinforce suicidal behavior if used as an escape from life stressors (Correct answer)
- Hospitalization is never appropriate in DBT treatment
- Hospitalization decisions are made solely by the client
Correct answer: Hospitalization should be used judiciously as it can reinforce suicidal behavior if used as an escape from life stressors
DBT emphasizes using hospitalization carefully and only when truly necessary, as frequent or automatic hospitalization can inadvertently reinforce suicidal behavior by removing the client from life stressors.
Question 4: What is the 'STOP' skill in DBT distress tolerance?
- Sleep, Talk, Observe, Plan
- Stop, Take a step back, Observe, Proceed mindfully (Correct answer)
- Soothe, Think, Opt out, Problem solve
- Stabilize, Tolerate, Open up, Practice
Correct answer: Stop, Take a step back, Observe, Proceed mindfully
STOP stands for Stop, Take a step back, Observe, and Proceed mindfully — a skill for pausing and creating space before reacting impulsively in a crisis.
Question 5: In DBT, what is the 'dialectical dilemma' of 'active passivity vs. apparent competence'?
- A conflict between therapist and client about treatment goals
- Clients oscillating between helpless passivity in getting needs met and appearing more capable than they are, making it hard to get appropriate help (Correct answer)
- A dilemma about whether to use active or passive coping strategies
- Conflicting skill sets in the four DBT modules
Correct answer: Clients oscillating between helpless passivity in getting needs met and appearing more capable than they are, making it hard to get appropriate help
Active passivity vs. apparent competence describes how BPD clients may passively rely on others to solve problems while also appearing so competent that others fail to provide necessary support.
Question 6: Which DBT concept refers to behaviors that threaten to disrupt therapy itself?
- Quality of life interfering behaviors
- Therapy-interfering behaviors (TIBs) (Correct answer)
- Crisis behaviors
- Parasuicidal behaviors
Correct answer: Therapy-interfering behaviors (TIBs)
Therapy-interfering behaviors (TIBs) are the second priority in DBT's hierarchy and include actions by clients or therapists that threaten to undermine or end the therapeutic relationship.
DBT DBT Crisis Intervention and Safety 2
In DBT, what is the primary goal of 'safety planning'?