DBT DBT Crisis Intervention and Safety 1 — Questions and Answers
Question 1: In DBT, what is the '24-hour rule' for phone coaching?
- Clients must call within 24 hours of a crisis
- Clients do not receive phone coaching for 24 hours after engaging in self-harm (Correct answer)
- Therapists must respond within 24 hours to all messages
- Skills group sessions last 24 hours
Correct answer: Clients do not receive phone coaching for 24 hours after engaging in self-harm
The 24-hour rule states that clients who engage in self-harm lose access to phone coaching for the next 24 hours to avoid inadvertently reinforcing self-harm with therapist attention.
Question 2: What is 'parasuicidal behavior' as defined in DBT?
- Suicidal ideation without intent
- Any intentional acute self-injurious act, regardless of suicidal intent (Correct answer)
- Behavior that mimics suicide attempts for attention
- Suicidal behavior in people with psychosis
Correct answer: Any intentional acute self-injurious act, regardless of suicidal intent
In DBT, parasuicidal behavior refers to any intentional, acute, self-injurious act regardless of whether there is suicidal intent, including NSSI and suicide attempts.
Question 3: How does DBT approach the topic of suicide differently from traditional crisis intervention?
- DBT avoids discussing suicide directly
- DBT addresses suicidal behavior directly and behaviorally, treating it as a problem to be solved through skill building (Correct answer)
- DBT always recommends hospitalization for suicidal ideation
- DBT ignores suicidal ideation until a plan is present
Correct answer: DBT addresses suicidal behavior directly and behaviorally, treating it as a problem to be solved through skill building
DBT takes a direct, behaviorally-oriented approach to suicidality, treating suicidal behaviors as maladaptive coping strategies to be replaced with skills rather than avoided.
Question 4: What is 'crisis survival' in DBT distress tolerance?
- Long-term coping strategies for chronic stress
- Short-term skills to get through intense emotional crises without making things worse (Correct answer)
- Emergency hospitalization procedures
- Crisis hotline counseling techniques
Correct answer: Short-term skills to get through intense emotional crises without making things worse
Crisis survival skills in DBT are short-term distress tolerance strategies designed to help clients get through high-intensity emotional crises without engaging in harmful behaviors.
Question 5: Which DBT skill involves putting your face in cold water to rapidly reduce emotional intensity?
- Paced breathing
- Temperature change (Cold water dive response) (Correct answer)
- Progressive muscle relaxation
- Mindful observation
Correct answer: Temperature change (Cold water dive response)
The cold water temperature skill in TIPP activates the dive reflex by submerging the face in cold water, rapidly slowing heart rate and reducing emotional intensity.
Question 6: What is 'urge surfing' in DBT crisis intervention?
- Using internet resources to find coping strategies during a crisis
- Mindfully observing an urge as it rises and falls without acting on it (Correct answer)
- Surfing social media to distract from urges
- A group activity for crisis support
Correct answer: Mindfully observing an urge as it rises and falls without acting on it
Urge surfing is a mindfulness-based technique where clients observe their urge to engage in harmful behavior as a wave that rises, peaks, and falls without acting on it.
DBT DBT Crisis Intervention and Safety 1
In DBT, what is the '24-hour rule' for phone coaching?