DBT. Recovery. DBT. Recovery. CBT/Behaviourism. CBT/Behaviourism.

Common Core PhilosophyCommon Core Philosophy

Hope. Hope.

Central to Recovery. Central to Recovery. DBT: the life worth living. DBT: the life worth living. CBT. Cognition and behaviour can CBT. Cognition and behaviour can

change. You can choose.change. You can choose.

Working with strengths.Working with strengths.All look at the whole person, not the All look at the whole person, not the

pathology.pathology.

Recovery: regaining or developing Recovery: regaining or developing valued roles. valued roles.

DBT. Encouraging mastery. DBT. Encouraging mastery. CBT. Focus on behaviour to increase CBT. Focus on behaviour to increase

– what the person can do as opposed – what the person can do as opposed to what they do wrong. to what they do wrong.

Normalisation.Normalisation.

Recovery. Building a life outside the Recovery. Building a life outside the services; employment focus. services; employment focus.

DBT. Biopsychosocial model applies DBT. Biopsychosocial model applies to some degree to everyone. to some degree to everyone.

CBT. We all have dysfunctional CBT. We all have dysfunctional thinking patterns and challenging thinking patterns and challenging behaviours sometimes.behaviours sometimes.

Common humanity, common Common humanity, common vulnerability.vulnerability.

Recovery. Trainers devise their own WRAP plans. Recovery. Trainers devise their own WRAP plans. Encouragement of employment of those who Encouragement of employment of those who have recovered in the services (experts by have recovered in the services (experts by experience). experience).

DBT. Therapists note own therapy intefering DBT. Therapists note own therapy intefering behaviours, dialectical dilemmas and emotion behaviours, dialectical dilemmas and emotion mind.mind.

CBT. Therapists monitor the effect of challenging CBT. Therapists monitor the effect of challenging behaviour on their own arousal systems and behaviour on their own arousal systems and thought patterns, and sidestep reproducing the thought patterns, and sidestep reproducing the pattern or responding from the raised state of pattern or responding from the raised state of arousal.arousal.

Collaboration.Collaboration.

Recovery; service user sets the Recovery; service user sets the agenda. agenda.

DBT. Client must agree to work on DBT. Client must agree to work on reducing self harm as a first priority, reducing self harm as a first priority, but the life worth living is their own but the life worth living is their own vision. vision.

CBT – goals of therapy are arrived at CBT – goals of therapy are arrived at collaboratively.collaboratively.

Accepting realityAccepting reality

Recovery. The concept of the turning point Recovery. The concept of the turning point means the point at which the individual means the point at which the individual recognises whatever limitations are recognises whatever limitations are imposed by their problems, and accepts imposed by their problems, and accepts what has happened in the past – this makes what has happened in the past – this makes taking ownership of their future possible.taking ownership of their future possible.

DBT. Acceptance is a core concept. DBT. Acceptance is a core concept. CBT. Individual needs to be prepared to CBT. Individual needs to be prepared to

take responsibility for change.Work on take responsibility for change.Work on changing what’s changeable - no point changing what’s changeable - no point challenging an unchallengeable thought.challenging an unchallengeable thought.

Self MonitoringSelf Monitoring

Recovery: PIP.Identify wellness, and Recovery: PIP.Identify wellness, and then triggers and early warning signs then triggers and early warning signs for relapse.for relapse. Relapse is a normal part Relapse is a normal part of recovery.of recovery.

DBT: Diary cards.Chain analysis.DBT: Diary cards.Chain analysis. CBT: Thought Diaries.CBT: Thought Diaries.

Response to Risk and Response to Risk and challenge.challenge.

Recovery. PIP – individual responsibility for Recovery. PIP – individual responsibility for maintaining wellness and specifying what maintaining wellness and specifying what should happen in case of breakdown.should happen in case of breakdown.

DBT. Skills training, featuring mindfulness, DBT. Skills training, featuring mindfulness, to master action urges.to master action urges.

CBT. Specifying behaviours to increase CBT. Specifying behaviours to increase and reinforcing them is the most efficient and reinforcing them is the most efficient way to decrease challenging behaviours.way to decrease challenging behaviours.

Idea of Balance and Finding a Idea of Balance and Finding a Middle WayMiddle Way

Recovery. Balance between learning to live with Recovery. Balance between learning to live with symptoms and a relapsing condition, and making symptoms and a relapsing condition, and making the most of life.the most of life.

DBT. Always looking for the dialectic, and for the DBT. Always looking for the dialectic, and for the wisdom in both poles while seeking a way wisdom in both poles while seeking a way through. There is no one right way – the process through. There is no one right way – the process carries on.carries on.

Behavioural approach to challenging Behavioural approach to challenging behaviour – balancing the obvious, behaviours to behaviour – balancing the obvious, behaviours to decrease with emphasis on behaviours to decrease with emphasis on behaviours to increase.increase.

CBT: you can choose the most helpful way to CBT: you can choose the most helpful way to think about things.think about things.

Unique featuresUnique features

Recovery. Service users, not Recovery. Service users, not professionals, in charge.professionals, in charge.

DBT. Skills training and mindfulness.DBT. Skills training and mindfulness. CBT. Individual formulation of CBT. Individual formulation of

difficulties.difficulties.

However – the similarities are more However – the similarities are more striking and numerous than the striking and numerous than the differences.differences.

Common Core Philosophy.Common Core Philosophy.

HopeHope Working with strengths.Working with strengths. Normalisation.Normalisation. Common humanity, common vulnerability.Common humanity, common vulnerability. Collaboration.Collaboration. Accepting reality.Accepting reality. Idea of Balance and Finding a Middle Way.Idea of Balance and Finding a Middle Way. Proactive, collaborative response to risk Proactive, collaborative response to risk

and challenge. and challenge.

Implications for staff role.Implications for staff role.

Staff need to hold hope and vision for the individual even when Staff need to hold hope and vision for the individual even when they cannot yet see it.they cannot yet see it.

Staff need to concentrate their efforts on identifying and working Staff need to concentrate their efforts on identifying and working with the person’s strengths and interests.with the person’s strengths and interests.

Staff need to see the person as they might fit into society to help Staff need to see the person as they might fit into society to help them maximise their prospects. They need to listen to the person them maximise their prospects. They need to listen to the person and take seriously what they say.and take seriously what they say.

Staff need to be aware of and manage their own emotional Staff need to be aware of and manage their own emotional reactions.reactions.

Staff need to develop their skill in working collaboratively.Staff need to develop their skill in working collaboratively. Staff have a vital role in enabling the person to accept what has Staff have a vital role in enabling the person to accept what has

happened and its consequences, and take responsibility for happened and its consequences, and take responsibility for continuing problems.continuing problems.

Staff must keep in mind the need to balance working with Staff must keep in mind the need to balance working with strengths with realistic support with problems.strengths with realistic support with problems.

In managing risk, staff need to seek the full collaboration of the In managing risk, staff need to seek the full collaboration of the service user.service user.